Stepanov V.K., Marieva I.V., Isaeva O.V.
THERAPEUTIC CORNEAL TRANSPLANTATION IN DESTRUCTIVE KERATOPATHY IN PATIENTS WITH RHEUMATOID ARTHRITIS ^{[№ 12 ' 2015]}
Authors produced results of therapeutic corneal grafting on patients with destructive corneal pathology, which was associated with rheumatoid polyarthritis. There were 27 patients (18 women, 9 men) aged from 52 to 82. Destructive processes looked like deep clean corneal ulcers. There were 14 patients with uncovered descemet's membrane, 7 patients had perforation of the cornea, 8 patients had destructive corneal processes through 2–3 months after cataract extraction with IOL implantation. We have made therapeutic lamellar keratoplasty by own technology in all of cases, because conservative treatment was ineffective. In 15 patients we added to keratoplasty amniotic membrane covering and blepharorrhaphy, it allowed us check out these patients from the hospital on next day. In 23 patients recovery happened after first surgery, in 4 patients we have seen relapse disease in long-term period through 1–2 months. In 2 patients recovery happened after repeated surgery and in 1 patient after third surgery. Corneal transplant has regenerated transparent in 12 patients, half-transparent in 11 patients and opacity cornea in 4 patients. All patient's eyes were saved with vision function to 0.1. In this way, the lamellar keratoplasty gave effective result with saving of eyes in all patients with hard destruction of the cornea, which was associated with rheumatoid polyarthritis. Amniotic membrane covering of corneal transplant and blepharorrhaphy allowed to use postoperative treatment outpatient with observing in the Eye hospital, it was comfortable for patients and was cost effective for hospital.