Dependable covering of keratoprosthesis with temporal fascia autograft

Purpose. To propose a surgical technique to secure keratoprosthesis from protrusion by covering the plate with temporal fascia autograft. Material and methods. This study included 17 patients (17 eyes) with corneal leucoma, who underwent surgery of covering the leucoma with temporal fascia autograft...

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Main Authors: M.G. Kataev, A.V. Golovin, O.N. Nefedova, I.Yu. Trofimova
Format: Article
Language:Russian
Published: Publishing house "Ophthalmology" 2024-06-01
Series:Офтальмохирургия
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Online Access:https://ophthalmosurgery.ru/index.php/ophthalmosurgery/article/view/624/894
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author M.G. Kataev
A.V. Golovin
O.N. Nefedova
I.Yu. Trofimova
author_facet M.G. Kataev
A.V. Golovin
O.N. Nefedova
I.Yu. Trofimova
author_sort M.G. Kataev
collection DOAJ
description Purpose. To propose a surgical technique to secure keratoprosthesis from protrusion by covering the plate with temporal fascia autograft. Material and methods. This study included 17 patients (17 eyes) with corneal leucoma, who underwent surgery of covering the leucoma with temporal fascia autograft at the first stage of keratoprosthesis implantation (6 eyes), or transplantation of corneal-prosthetic complex (4 eyes) or protrusion of the keratoprosthesis supporting plate (7 eyes). 4 cm long skin linear incision was performed, temporal fascia autograft 15–18 mm in diameter was harvested and placed on cornea, fixed to the sclera by 8 peripheral not absorbable sutures. Flaps of Tenon’s capsule was undermined in the intermuscular quadrants and sutured together by purse absorbable suture covering the autograft. Conjunctiva was closed by running absorbable suture. Eyelids were secured together by one blepharorrhaphy stich. Patients were examined before surgery, 7–10 days and 6 months after surgery. The follow-up period was on average 18 months. Results. The depth of the keratoprosthesis supporting plate at least 6 months after surgery was on average 1141 μm. The following postoperative complications were noted: in 6 (35.3%) cases the optical cylinder of keratoprosthesis became overgrown. In one case (5.9%) the optical cylinder was opened by a local excision of the conjunctiva. In 5 cases (29.4%) the optical cylinder was replaced with a higher one. In one case (5.9%) protrusion of the keratoprosthesis supporting plate occurred and the leucoma was re-covered with temporal fascia autograft. In other cases, the keratoprosthesis supporting plate was tightly fused with the underlying tissues of the leucoma and its position was stable. Conclusion. The use of a temporal fascia autograft is an accessible and effective method of dependable covering of leucoma in the prevention of protrusions during the simultaneous first stage of keratoprosthesis, transplantation of the corneal-prosthetic complex and at the beginning stage of keratoprosthesis protrusion.
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publisher Publishing house "Ophthalmology"
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series Офтальмохирургия
spelling doaj-art-71d070fe31c449bcbfa1b62879bf26bd2025-08-20T02:30:09ZrusPublishing house "Ophthalmology"Офтальмохирургия0235-41602312-49702024-06-012139435110.25276/0235-4160-2024-2-43-51Dependable covering of keratoprosthesis with temporal fascia autograftM.G. Kataev0https://orcid.org/0000-0002-3038-7918A.V. Golovin1https://orcid.org/0000-0001-7577-1289O.N. Nefedova2https://orcid.org/0000-0002-2126-000XI.Yu. Trofimova3https://orcid.org/0009-0000-1707-9454S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian FederationS. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian FederationS. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian FederationS. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian FederationPurpose. To propose a surgical technique to secure keratoprosthesis from protrusion by covering the plate with temporal fascia autograft. Material and methods. This study included 17 patients (17 eyes) with corneal leucoma, who underwent surgery of covering the leucoma with temporal fascia autograft at the first stage of keratoprosthesis implantation (6 eyes), or transplantation of corneal-prosthetic complex (4 eyes) or protrusion of the keratoprosthesis supporting plate (7 eyes). 4 cm long skin linear incision was performed, temporal fascia autograft 15–18 mm in diameter was harvested and placed on cornea, fixed to the sclera by 8 peripheral not absorbable sutures. Flaps of Tenon’s capsule was undermined in the intermuscular quadrants and sutured together by purse absorbable suture covering the autograft. Conjunctiva was closed by running absorbable suture. Eyelids were secured together by one blepharorrhaphy stich. Patients were examined before surgery, 7–10 days and 6 months after surgery. The follow-up period was on average 18 months. Results. The depth of the keratoprosthesis supporting plate at least 6 months after surgery was on average 1141 μm. The following postoperative complications were noted: in 6 (35.3%) cases the optical cylinder of keratoprosthesis became overgrown. In one case (5.9%) the optical cylinder was opened by a local excision of the conjunctiva. In 5 cases (29.4%) the optical cylinder was replaced with a higher one. In one case (5.9%) protrusion of the keratoprosthesis supporting plate occurred and the leucoma was re-covered with temporal fascia autograft. In other cases, the keratoprosthesis supporting plate was tightly fused with the underlying tissues of the leucoma and its position was stable. Conclusion. The use of a temporal fascia autograft is an accessible and effective method of dependable covering of leucoma in the prevention of protrusions during the simultaneous first stage of keratoprosthesis, transplantation of the corneal-prosthetic complex and at the beginning stage of keratoprosthesis protrusion.https://ophthalmosurgery.ru/index.php/ophthalmosurgery/article/view/624/894keratoprosthesiskeratoprosthesis protrusiontemporal fascialeucoma covering
spellingShingle M.G. Kataev
A.V. Golovin
O.N. Nefedova
I.Yu. Trofimova
Dependable covering of keratoprosthesis with temporal fascia autograft
Офтальмохирургия
keratoprosthesis
keratoprosthesis protrusion
temporal fascia
leucoma covering
title Dependable covering of keratoprosthesis with temporal fascia autograft
title_full Dependable covering of keratoprosthesis with temporal fascia autograft
title_fullStr Dependable covering of keratoprosthesis with temporal fascia autograft
title_full_unstemmed Dependable covering of keratoprosthesis with temporal fascia autograft
title_short Dependable covering of keratoprosthesis with temporal fascia autograft
title_sort dependable covering of keratoprosthesis with temporal fascia autograft
topic keratoprosthesis
keratoprosthesis protrusion
temporal fascia
leucoma covering
url https://ophthalmosurgery.ru/index.php/ophthalmosurgery/article/view/624/894
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AT avgolovin dependablecoveringofkeratoprosthesiswithtemporalfasciaautograft
AT onnefedova dependablecoveringofkeratoprosthesiswithtemporalfasciaautograft
AT iyutrofimova dependablecoveringofkeratoprosthesiswithtemporalfasciaautograft