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Long-term visual prognosis of corneal and ocular surface surgery in patients with congenital aniridia
Article first published online: 9 JUL 2008
DOI: 10.1111/j.1755-3768.2008.01293.x
© 2008 The Authors. Journal compilation © 2008 Acta Ophthalmol
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How to Cite
De La Paz, M. F., Alvarez de Toledo, J., Barraquer, R. I. and Barraquer, J. (2008), Long-term visual prognosis of corneal and ocular surface surgery in patients with congenital aniridia. Acta Ophthalmologica, 86: 735–740. doi: 10.1111/j.1755-3768.2008.01293.x
Publication History
- Issue published online: 29 OCT 2008
- Article first published online: 9 JUL 2008
- Received on October 17th, 2007. Accepted on March 21st, 2008.
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Keywords:
- congenital aniridia;
- limbal insufficiency;
- limbal transplantation;
- penetrating keratoplasty;
- prognosis
Abstract.
Purpose: To evaluate the long-term visual prognosis of corneal and ocular surface surgery in patients with congenital aniridia.
Methods: Retrospective comparative interventional case series on 88 eyes of 45 patients with congenital aniridia treated and/or operated on from 1956 to present. Corneal and ocular surface findings were identified and patients were classified into operated (group I) or not operated (group II). Long-term best-ever best-corrected visual acuity (BCVA), final BCVA and long-term delta BCVA (long-term best-ever BCVA – final BCVA) were recorded and compared between the two groups, and between the limbal transplant (LT) (group I-A) and the penetrating keratoplasty (PK) (group I-B) patients. Postoperative results were also compared.
Results: Limbal insufficiency was present in 58% of eyes and dense central corneal opacities were present in 27% of eyes. As a primary surgery, limbal allograft was performed in 10 eyes and PK in 13 eyes. The mean long-term follow-up times were 23 years in group I and 16 years in group II. The mean long-term delta BCVA was 0.032 in group I and 0.028 in group II. Comparisons of the VA means were insignificant (long-term best-ever, final BCVA and long-term delta BCVA). When comparing the LT and PK groups, mean long-term delta BCVA was 0.0328 in group I-A and 0.0382 in group I-B. Mean postoperative delta BCVA was 0.028 in group I-A and 0.048 in group I-B. We found no statistical significance between the LT and the PK groups as regards long-term postoperative BCVA results.
Conclusion: Long-term visual prognosis does not differ whether or not the patient undergoes surgery for aniridic keratopathy. LT and PK have comparable results over 5 years of follow-up because of the eventual failure of transplanted allografts.