Clinical study of tectonic surgery for rheumatic diseases associated corneal melting

AIM: To explore the indications, efficacy, and complications of different types tectonic surgery for rheumatic diseases associated corneal melting.METHODS: It was a retrospective case series study. Sixteen patients(19 eyes)with rheumatic diseases associated corneal melting underwent surgery for tectonic indications at the General Hospital of Shenyang Military Region between January 2008 and August 2012 were involved. The selection of surgical procedures was based on the preoperative corneal status(location, depth and area). These include penetrating keratoplasty(4 eyes), deep lamellar keratoplasty(8 eyes), corneal(scleral)patch grafts(5 eyes)and amniotic membrane transplantation(5 eyes). Concomitant systemic disease, indication for tectonic graft, preoperative visual acuity, postoperative visual acuity and postoperative complications were recorded and studied during the follow-up period of 1 year. Efficacy was evaluated by the outcomes of cured or improved or invalid.RESULTS: Corneal melting were completely cured in 12 eyes, improved in 5 eyes and showed invalid in 2 eyes. Visual acuity in 7 eyes(36.8%)was improved after operation. Postoperative complications included graft melting in 3 eyes, persistent corneal epithelium defect in 3 eyes, secondary glaucoma in 1 eye, complicated cataract in 1 eye. CONCLUSION: Designing the appropriate type of tectonic surgery based on the different preoperative corneal status allows the removal of the corneal lesion and spares the maximum amount of normal tissue. It is an effective approach for preservation of eyeballs and restoration of visual function