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PRECIS: Three-dimensional (3D) spectral domain optical coherence tomography (OCT) volume scans of the optic nerve head (ONH) and the peripapillary area are useful in the management of glaucoma in patients with a type I or II Boston Keratoprosthesis (KPro). PURPOSE: The purpose of this study was to report the use of spectral domain OCT in the management of glaucoma in patients with a type I or II Boston KPro. MATERIALS AND METHODS: This study is an observational case series. Four consecutive patients with KPro implants were referred for glaucoma evaluation. A comprehensive eye examination was performed which included disc photography, visual field testing, and high-density spectral domain OCT volume scans of the ONH and the peripapillary area. 2D and 3D parameters were calculated using custom-designed segmentation algorithms developed for glaucoma management. RESULTS: Spectral domain OCT parameters provided useful information in the diagnosis and management of 4 KPro patients. OCT parameters which can be used in KPro patients included 2D retinal nerve fiber layer (RNFL) thickness, 3D peripapillary RNFL volume, 3D peripapillary retinal thickness and volume, 3D cup volume, and 3D neuroretinal rim thickness and volume. In 3 of 4 cases where the traditional 2D RNFL thickness scan was limited by artifacts, 3D spectral domain OCT volume scans provided useful quantitative objective measurements of the ONH and peripapillary region. Therefore, 3D parameters derived from high-density volume scans as well as radial scans of the ONH can be used to overcome the limitations and artifacts associated with 2D RNFL thickness scans. CONCLUSIONS: Spectral domain OCT volume scans offer the possibility to enhance the evaluation of KPro patients with glaucoma by using both 2D and 3D diagnostic parameters that are easily obtained in a clinic setting.

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Thanks to technical advances the surgical options for corneal grafting have been widely expanded in recent years. Promoted by new instruments and techniques for intrastromal dissection a number of variations of lamellar keratoplasty, including descriptive terms and abbreviations have been suggested. This creative chaos, however, lacks simplicity, specificity and structure. Following a short definition of the basic terms we here present a simplified and clearly structured classification, which also incorporates the Anglo-American terminology and should, therefore, be acceptable for the wider international ophthalmic community.

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Based on analysis of 750 reconstructive operations on the anterior segment of the eye, the authors classify simultaneous reconstructive interventions based on perforating keratoplasty with implantation of posterior chamber intraocular lens (IOL). Indications, terms, and technological features of such operations are defined with due consideration for the etiology of involvement of the anterior segment of the eye, corneal status, presence of the lens, and intactness of the lenticular posterior capsule. Disk posterior chamber IOLs with intracapsular fixation are preferred (in case of an intact capsule sac, with suturing to the posterior surface of the cornea) in the absence of the posterior capsule of the lens. As a result of surgery, improvement of visual acuity by 0.04-0.8 was attained in 720 patients.

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A fim de verificar alteraçöes nas indicaçöes de ceratoplastia penetrante (CP) no Hospital Säo Geraldo (UFMG) foram revistos os prontuários de 265 pacientes submetidos a CP de 1983-87 e 1988-92. O sexo masculino representou 56,3 por cento dos pacientes e 65 por cento encocontravam-se entre 10 e 49 anos. As principais indicaçöes de CP foram: ceratocone-66 casos (24,9 por cento), leucoma-60 casos (22,6 por cento), opacificaçäo pós-transplante-53 casos (20 por cento), ceratopatia bolhosa-41 casos (15,5 por cento), ceratites-17 casos (6,4 por cento) e distrofias- 14 casos (5,3 por cento). A maior média de idade ocorreu na ceratopatia bolhosa (56,5 anos) e a enor o ceratocone (22,5 anos). A distribuiçäo dos 265 casos de CP com relaçäo à frequência das indicaçöes por período mostrou diminuiçäo do leucoma (27,9 por cento em 83-87 e 20,7 por cento em 88-92). O autal estudo mostra o ceratocone como principal indicaçäo de transplante, discordando da maioria dos estudos que aponta a ceratopatia bolhosa. Foram detectadas alteraçöes evidentes nas indicaçöes de CP entre os dois períodos analisados nesse estudo

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Uma série de 268 ceratoplastias penetrantes realizadas no Instituto Penido Burnier no período de janeiro de 1985 a dezembro de 1989 foram analisadas, quanto a indicaçäo, sexo e idade. O ceratocone foi a maior indicaçäo para a ceratoplastia penetrante (46,64 por cento), seguido de re-enxerto (14,18 por cento), leucoma (13,80 por cento), ceratite bolhosa (9,33 por cento), distrofia e degeneraçäo näo Fuchs (4,85 por cento), trauma físico (3,73 por cento), Fuchs (2,24 por cento), ceratite a vírus (2,24 por cento) e queimadura química (0,75 por cento). A incidência quanto ao sexo foi de 53,74 por cento do sexo masculino e 46,26 por cento do sexo feminino. A idade variou de 10 meses a 86 anos, numa média de 34,82 anos

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Estudamos retrospectivamente os diagnósticos clínico e patológico de 49 ceratoplastias penetrantes realizadas no período de abril de 1988 a março de 1989, em 2 instituiçöes de ensino: Hospital Universitário Antônio Pedro, da Universidade Federal Fluminense. As indicaçöes mais frequentes, em ordem decrescente de frequência, foram a ceratopatia bolhosa da afacia (22,45%), a distrofia endotelial de Fuchs (16,33%), o ceratocone (14,28%), a ceratite intersticial (10,20%) e os re-enxertos (10,20%)

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