Lens opacities after nonmechanical versus mechanical corneal trephination for keratoplasty in keratoconus

Ashley Behrens, Berthold Seitz, Achim Langenbucher, Murat M. Kus, Michael Küchle, Gottfried O H Naumann

Research output: Contribution to journalArticle

Abstract

Purpose: To compare the lens opacity formation after penetrating keratoplasty (PKP) using nonmechanical excimer laser corneal trephination and mechanical motor trephination. Setting: University Eye Clinic, University of Erlangen-Nunberg, Erlangen, Germany. Methods: Ninety-six patients with keratoconus (96 eyes) and clear crystalline lenses were randomiy assigned to the nonmechanical trephination (NMT) group (n = 46; 35 men; mean age 38.2 years ± 10.8 [SD]) or the mechanical trephination (MT) group (n = 50; 35 men; mean age 34.4 ± 9.0 years). Suturing and postoperative treatment were identical. Dilated pupil biomicroscopy and slitlamp lens photography were performed preoperatively and postoperatively at 3 month intervals. Opacities were identified as cortical, nuclear, and posterior subcapsular and graded from 1 (mild) to 3 (severe). Results: Mean follow-up in the NMT/MT group was 3.2 ± 1.3 years/3.4 ± 1.1 years. Overall, incident opacities appeared in 23.9%/32.0% of eyes (4.3%/6.0% cortical; 19.6%/26.0% posterior subcapsular; 0%/0% nuclear) (P = .833). All cortical opacities in both groups were grade 1; posterior subcapsular opacities were grade 1 in 66.6%/61.5% of eyes and grade 2 in 22.2%/30.8% of eyes. One patient in each group presented grade 3 posterior subcapsular opacities. No differences between trephination methods were seen in a 5 year Kaplan-Meier cumulative 2risk of lens opacity formation (P = .763 cortical, P = .530 posterior subcapsular). Conclusion: In addition to its optical advantages, nonmechanical corneal trephination appears to have no adverse impact on cataract formation after PKP for keratoconus. (C) 2000 ASCRS and ESCRS.

Original languageEnglish (US)
Pages (from-to)1605-1611
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume26
Issue number11
DOIs
StatePublished - 2000
Externally publishedYes

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Trephining
Keratoconus
Corneal Transplantation
Cataract
Penetrating Keratoplasty
Naphazoline
Excimer Lasers
Crystalline Lens
Photography
Pupil
Lenses
Germany

ASJC Scopus subject areas

  • Ophthalmology

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Lens opacities after nonmechanical versus mechanical corneal trephination for keratoplasty in keratoconus. / Behrens, Ashley; Seitz, Berthold; Langenbucher, Achim; Kus, Murat M.; Küchle, Michael; Naumann, Gottfried O H.

In: Journal of Cataract and Refractive Surgery, Vol. 26, No. 11, 2000, p. 1605-1611.

Research output: Contribution to journalArticle

Behrens, Ashley ; Seitz, Berthold ; Langenbucher, Achim ; Kus, Murat M. ; Küchle, Michael ; Naumann, Gottfried O H. / Lens opacities after nonmechanical versus mechanical corneal trephination for keratoplasty in keratoconus. In: Journal of Cataract and Refractive Surgery. 2000 ; Vol. 26, No. 11. pp. 1605-1611.
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abstract = "Purpose: To compare the lens opacity formation after penetrating keratoplasty (PKP) using nonmechanical excimer laser corneal trephination and mechanical motor trephination. Setting: University Eye Clinic, University of Erlangen-Nunberg, Erlangen, Germany. Methods: Ninety-six patients with keratoconus (96 eyes) and clear crystalline lenses were randomiy assigned to the nonmechanical trephination (NMT) group (n = 46; 35 men; mean age 38.2 years ± 10.8 [SD]) or the mechanical trephination (MT) group (n = 50; 35 men; mean age 34.4 ± 9.0 years). Suturing and postoperative treatment were identical. Dilated pupil biomicroscopy and slitlamp lens photography were performed preoperatively and postoperatively at 3 month intervals. Opacities were identified as cortical, nuclear, and posterior subcapsular and graded from 1 (mild) to 3 (severe). Results: Mean follow-up in the NMT/MT group was 3.2 ± 1.3 years/3.4 ± 1.1 years. Overall, incident opacities appeared in 23.9{\%}/32.0{\%} of eyes (4.3{\%}/6.0{\%} cortical; 19.6{\%}/26.0{\%} posterior subcapsular; 0{\%}/0{\%} nuclear) (P = .833). All cortical opacities in both groups were grade 1; posterior subcapsular opacities were grade 1 in 66.6{\%}/61.5{\%} of eyes and grade 2 in 22.2{\%}/30.8{\%} of eyes. One patient in each group presented grade 3 posterior subcapsular opacities. No differences between trephination methods were seen in a 5 year Kaplan-Meier cumulative 2risk of lens opacity formation (P = .763 cortical, P = .530 posterior subcapsular). Conclusion: In addition to its optical advantages, nonmechanical corneal trephination appears to have no adverse impact on cataract formation after PKP for keratoconus. (C) 2000 ASCRS and ESCRS.",
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T1 - Lens opacities after nonmechanical versus mechanical corneal trephination for keratoplasty in keratoconus

AU - Behrens, Ashley

AU - Seitz, Berthold

AU - Langenbucher, Achim

AU - Kus, Murat M.

AU - Küchle, Michael

AU - Naumann, Gottfried O H

PY - 2000

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AB - Purpose: To compare the lens opacity formation after penetrating keratoplasty (PKP) using nonmechanical excimer laser corneal trephination and mechanical motor trephination. Setting: University Eye Clinic, University of Erlangen-Nunberg, Erlangen, Germany. Methods: Ninety-six patients with keratoconus (96 eyes) and clear crystalline lenses were randomiy assigned to the nonmechanical trephination (NMT) group (n = 46; 35 men; mean age 38.2 years ± 10.8 [SD]) or the mechanical trephination (MT) group (n = 50; 35 men; mean age 34.4 ± 9.0 years). Suturing and postoperative treatment were identical. Dilated pupil biomicroscopy and slitlamp lens photography were performed preoperatively and postoperatively at 3 month intervals. Opacities were identified as cortical, nuclear, and posterior subcapsular and graded from 1 (mild) to 3 (severe). Results: Mean follow-up in the NMT/MT group was 3.2 ± 1.3 years/3.4 ± 1.1 years. Overall, incident opacities appeared in 23.9%/32.0% of eyes (4.3%/6.0% cortical; 19.6%/26.0% posterior subcapsular; 0%/0% nuclear) (P = .833). All cortical opacities in both groups were grade 1; posterior subcapsular opacities were grade 1 in 66.6%/61.5% of eyes and grade 2 in 22.2%/30.8% of eyes. One patient in each group presented grade 3 posterior subcapsular opacities. No differences between trephination methods were seen in a 5 year Kaplan-Meier cumulative 2risk of lens opacity formation (P = .763 cortical, P = .530 posterior subcapsular). Conclusion: In addition to its optical advantages, nonmechanical corneal trephination appears to have no adverse impact on cataract formation after PKP for keratoconus. (C) 2000 ASCRS and ESCRS.

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