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PENETRATING KERATOPLASTY FOR UNILATERAL CORNEAL OPACITIES IN PETERS' ANOMALY: A CASE SERIES

ASCRS 25-29/3/2011 SAN DIEGO- CALIFORNIA. PENETRATING KERATOPLASTY FOR UNILATERAL CORNEAL OPACITIES IN PETERS' ANOMALY: A CASE SERIES. The authors have no financial interest in the subject matter of this e-poster. Chrysanthi BASDEKIDOU, Pascal DUREAU.

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PENETRATING KERATOPLASTY FOR UNILATERAL CORNEAL OPACITIES IN PETERS' ANOMALY: A CASE SERIES

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  1. ASCRS 25-29/3/2011 SAN DIEGO- CALIFORNIA PENETRATING KERATOPLASTY FOR UNILATERAL CORNEAL OPACITIES IN PETERS' ANOMALY: A CASE SERIES The authors have no financial interest in the subject matter of this e-poster Chrysanthi BASDEKIDOU, Pascal DUREAU Basdekidou Chrysanthi

  2. 40,3% of congenital corneal opacities (Rezende R, Cornea 2004) 80% bilateral, 50-70% associated glacoma (Ciralsky J, Sem Ophthalmol 2007) Type 1 : central corneal opacity, all corneal layers, IC synechiae Type 2 : lens implication PETERS' ANOMALY (PETERS A. 1906) Basdekidou Chrysanthi

  3. METHODS AND RESULTS Basdekidou Chrysanthi

  4. SURGICAL TECHNIQUE POSTOPERATORY TREATMENT • Flieringa ring • single use trephine • donnor and receipient: 0,5 mm graft difference • 16 seperated knots (2 cases: additional running suture) • Corticoïdes (oral and local) and ciclosporine 2% local • Suture ablation: 1st and 2nd post operative months under GA • Amblyopia treatment: occlusion – regular optometry control Basdekidou Chrysanthi

  5. COMPLICATIONS Basdekidou Chrysanthi

  6. Basdekidou Chrysanthi

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  9. DISCUSSIONCiclosporine • Only one prospective study→ Ciclosporine 2% in pediatric ophthalmology: sure and efficient (Cosar CB, Eye & Contact lens 2003) • Enfants: immature immunitary system- high risk KT! • No established protocole-when shall we stop the treatment? • Oral use of CsA for 12 months for high risk KT (Hill JC, Ophthalmology 1994) Basdekidou Chrysanthi

  10. REJECTION RISK FACTORSYang LHH, Ophthalmology 1999 • Severeness of the disease stromal vessels, total limbal opacification, anterior synechiae in several quadrants • Glaucoma • CNS pathology • Grafts greater than 8 mm in diameter: independant factor • Ulterior grafts: inferior survival probability (Yang LLH Ophthalmology 2004) • Association between combined surgeries and rejection (Cowden Ophthalmology 1990) Basdekidou Chrysanthi

  11. LITTERATURE: ENCOURAGING RESULTS Basdekidou Chrysanthi

  12. CONCLUSIONS • KT aims at giving the pathologic eye a useful vision • Surgeon: Evaluation of anomaly's severity and Family Context: cooperative parents • Final decesion: the family, a life time commitment • Long term aggressive amblyopia treatment • Multidisciplinary follow-up Basdekidou Chrysanthi

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