CHALLENGES IN IMMEDIATE AND LONG-TERM POSTOPERATIVE MANAGEMENT IN PATIENTS WITH CORNEAL TRANSPLANT

Authors

  • Nicoleta ANTON Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • D. CHISELITA Oftaprof Clinic Iasi, Romania
  • A.C. NICA Colentina” Clinical Hospital, Bucharest, Romania
  • Raluca NEAGU MOVILA “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • Francesca Cristiana DOHOTARIU “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • Marina GAVRILAS “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • Augustina CEORNEA “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • Liliana IONESCU “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania
  • Camelia Margareta BOGDANICI Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Corneal transplantation is a procedure involving the partial or total replacement of a damaged cornea with a healthy one, serving multiple purposes such as improving visual acuity, for aesthetic reasons, and for tectonic support. The most common procedure used in our clinic is penetrating keratoplasty, which can be burdened with a series of intraoperative and postoperative complications. The aim: In this article, we will present our clinic’s experience with patients who have undergone and been diagnosed with corneal pathologies through penetrating keratoplasty technique, and the medium and long-term therapeutic difficulties encountered by these patients from 2020 to 2024, at the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital Iasi. Materials and methods: Patients with a history of chemical burns to the cornea, herpetic infection, keratoglobus associated with lagophthalmos, chronic smokers, and those with advanced pseudoexfoliative glaucoma in one eye are included. Results: Among the postoperative complications, infections and rejection reactions can occur between 2 weeks and 8 months and are quite challenging to manage. Postoperative infections can be present due to non-conforming sutures, prolonged use of contact lenses, and systemic immunosuppression. Rejection reactions can occur as early as two weeks, with corneal vascularization in the host cornea increasing the risk of graft rejection. Early identification and prompt treatment of inflammation and early infection are facilitating factors in preventing graft rejection. Conclusions: Although, in terms of survival, corneal transplantation is the most successful transplant performed in humans, rejection is still the main cause responsible for graft failure. Keratoplasty involves a lengthy healing process; preoperative evaluation and dialogue with the patient are essential to understand the benefits, possible complications, and the need for prolonged treatment.

Author Biographies

  • Nicoleta ANTON, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania

  • Camelia Margareta BOGDANICI, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Romania

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Additional Files

Published

2024-06-28

Issue

Vol. 128 No. 2 (2024): The Medical-Surgical Journal

Section

SURGERY

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