Keratoplasty

KERATOPLASTY

Q. 1

An indication for therapeutic keratoplasty is:

 A

Progressive corneal ulcer 

 B

Keratoconus

 C

Anterior staphyloma          

 D

High myopia

Q. 1

An indication for therapeutic keratoplasty is:

 A

Progressive corneal ulcer 

 B

Keratoconus

 C

Anterior staphyloma          

 D

High myopia

Ans. B

Explanation:

In keratoplasty the diseased corneal disc is replaced by a corresponding sized graft from a human cadaver eye.

Penetrating (full thickness) keratoplasty

Lamellar (partial thickness) keratoplasty

Keratoconus               

  • Interstitial keratins
  • Salzmann’s nodular dystrophy
  • Mycotic corneal ulcer
  • Corneal abscess
 

  • Corneal dystrophy
  • Disciform keratitis
  • Recurrent pterygia

Complications of keratoplasty

  • Anterior synechia
  • Vascularization
 

  • Secondary glaucoma
  • Rejection of graft

A corneal graft which be obtained within 4 hours of death carries good prognosis.


Q. 2

Percentage of endothelial cell loss during Descent’s membrane stripping in automated penetrating keratoplasty

 A

0-5%

 B

10-15%

 C

30-40%

 D

50-60%

Q. 2

Percentage of endothelial cell loss during Descent’s membrane stripping in automated penetrating keratoplasty

 A

0-5%

 B

10-15%

 C

30-40%

 D

50-60%

Ans. C

Explanation:

C i.e. 30-40%

The incidence of endothelial cell loss in donor tissue of Descemet stripping endothelial keratolplasty is nearly 36%, mainly in the central area of graft. Compared with penetrating keratoplasty, EK involves more donor-tissue manipulation including lamellar dissection and folding, which could potentially damage donor endothelium. On the other hand EK grafts are usually larger (8-9 mm diameter compared with typical PK diameter of 7 – 8mm) and provide a larger reservoir of healthy donor endothelium. However, several recent reports suggest that endothelial cell loss in first few years after EK is similar to that experienced after PK.


Q. 3

Deep anterior lamellar keratoplasty is indicated in:

 A

Disease of deeper cornea e.g. endothelial damage

 B

Full thickness corneal opacities

 C

Bullous keratopathy

 D

Superficial corneal opacities

Q. 3

Deep anterior lamellar keratoplasty is indicated in:

 A

Disease of deeper cornea e.g. endothelial damage

 B

Full thickness corneal opacities

 C

Bullous keratopathy

 D

Superficial corneal opacities

Ans. D

Explanation:

Ans. Superficial corneal opacities



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