Article
Current practice of mechanical surgery of the cornea – a survey from members of the cornea section of the DOG (German Ophthalmological Society)
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Authors
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P. Steven
- Eye-Hospital, University-Hospital Schleswig-Holstein, Campus Lübeck, Lübeck
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R. Winter
- Eye-Hospital, Medical University of Hannover, Hannover
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G. Geerling
- Eye-Hospital, University-Hospital Schleswig-Holstein, Campus Lübeck, Lübeck
| Published: | September 22, 2004 |
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Outline
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Objective
Aim of the study is to obtain information about the strategy and the management of mechanical surgery of the cornea by use of a questionnaire.
Methods
A questionaire was sent to 60 ophthalmological clinics in Germany, Switzerland and Austria obtaining information about e.g. the number and type of procedure, character of the donor material, type of the trephine system and the suture management. The return consisted of 48 out of 60 (80%). Within one year all responding clinics performed 3249 perforating keratoplasties, 256 lamellar keratoplasties, 224 limbusstemcell and 817 amniotic-membrane transplantations.
Results
Lamellar keratoplasty was performed by 29% of the clinics for optical and by 42 % for tectonical indication. Amniotic-membrane transplantation was performed by 71% and stemcell transplantation by 52 % of the clinics. In case of high-risk keratoplasty 33% of the clinics did not use HLA-matched grafts. More hand-held trephine systems than motor-driven or laser-assisted systems were used. 77% of the responding clinics used nylon 10.0 for the sutures, whereat 60% applied double running anti-torque sutures in case of normal-risk keratoplasty. For tectonic indications (ulceration) and high-risk keratoplasty for optical indication mainly interrupted running sutures were applied (70% and 56%). The suture removal was performed between 3 months (first suture) up to 36 months (second suture).
Conclusions
Apart from similarities concerning the suture material, mechanical surgery of the cornea is performed very un-uniformly among the participants of the questionaire. So far a possible influence on long time graft survival is unknown. In addition, a demand for alternative transplantation-materials (e.g. amniotic membrane) is identifiable.
