Abstract
Purpose: Positive vitreous pressure (PVP) secondary to intraoperative acute hypotony during penetrating keratoplasty can result in extrusion of the intraocular lens and vitreous. Currently described techniques are difficult or impossible to apply intraoperatively when positive vitreous pressure is noticed in an “open sky” situation after excision of the host corneal button. Methods: We describe a technique where pupil scaffolding is used to prevent intraocular lens or crystalline lens extrusion by simply closing the pupil with a temporary suture that holds the retropupillary contents back. Once the eye is thus stabilized, the donor cornea is sutured rapidly after which the pupillary knot is cut and removed using microscissors and microforceps. Results: Five patients undergoing penetrating keratoplasty under peribulbar anesthesia underwent this technique after experiencing PVP after host corneal button excision. PVP was successfully controlled in all 5 patients, and the optical grafts remained clear in the postoperative period. Conclusions: Temporary pupillary scaffolding can help control PVP and prevent ocular content extrusion during PKP surgeries.
Original language | English |
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Pages (from-to) | 1306-1309 |
Number of pages | 4 |
Journal | Cornea |
Volume | 43 |
Issue number | 10 |
DOIs | |
State | Published - 1 Oct 2024 |
Keywords
- IOL expulsion
- PK
- angle-closure glaucoma
- expulsive choroidal hemorrhage
- extrusion of lens
- low scleral rigidity
- open sky
- penetrating keratoplasty
- positive vitreous pressure
- pupil scaffolding
- pupillary closure
- pupilloplasty
- shallow anterior chamber
- stable anterior chamber
- temporary pupil scaffolding
- therapeutic keratoplasty
- vitreous extrusion
- vitreous loss
- zonulopathy
ASJC Scopus subject areas
- Ophthalmology