A retrospective analysis of outcomes of an optical reconstructive surgery combined with corneal transplantation dedicated to manage complications of inflammatory diseases of the anterior chamber of the ey

Background: full thickness corneal transplantation or penetrating keratoplasty (PK) is the only surgical method to manage outcomes of inflammatory diseases of the anterior eye chamber such as corneal ulcers associated with potential/existing perforation or corneal leukoma. Aim: to analyze the authors' own experience of outcomes of optical reconstructive interventions combined with PK performed considering condition of the paranasal sinuses (PS). Materials and Methods: a retrospective analysis was based on medical records of 33 patients (15 men and 18 women, average age — 52.7±6.1 years) within 2023-2024. 41 ophthalmosurgical interventions were performed in 35 eyes. Indications for corneal transplantation, causes of corneal damage, and PK outcomes were evaluated. The PS condition was assessed according imaging study protocols. Also, homo- or contralateral (relative to an affected eye) X-ray findings were analyzed. Results: corneal ulcer was an indication for PK in 18 cases. The second most common cause was corneal graft disease (CGD) (n=10), and PK was performed due to formation of corneal leukoma in 4 cases. A PK associated with simultaneous phacoemulsification and intraocular lens implantation was carried out to deal with corneal ulcer (n=4) and CGD (n=1). Along with this, the PK combined with simultaneous extracapsular cataract extraction (ECE) (n=3) was performed to manage gonococcal corneal ulcer, and the similar intervention was reported in case of CGD-induced rekeratoplasty (n=1). Ophthalmosurgical interventions and scheduled replacement contact lenses induced inflammatory corneal diseases (n=18). According to the imaging study data, bilateral (n=15) and homolateral SP damage (n=9) were the most common. In all cases, the performed interventions provided anatomical integrity of the eye. The maximum corrected visual acuity of <0.1 and higher was achieved (n=26). Conclusion: an optical reconstructive surgery combined with corneal transplantation was the only organ-preserving method In all the presented clinical observations. Chronic sinusitis (n=26) could be a reservoir of ascending bacterial and fungal flora, and, in turn, a cause of primary corneal damage (i. e., an ulcer) and subsequent CGD, respectively. KEYWORDS: corneal transplantation, penetrating keratoplasty, PK, high-risk PK, corneal ulcer, corneal perforation, corneal leukoma, chronic sinusitis, computed tomography of the paranasal sinuses. FOR CITATION: Arzhimatova G.Sh., Chernakova G.M., Salikhov E.A., Shirshova E.V., Shemyakin M.Yu., Ibraimov A.I., Obrubov A.S., Mamedzade N.R., Spirin D.V., Chernakov A.S. A retrospective analysis of outcomes of an optical reconstructive surgery combined with corneal transplantation dedicated to manage complications of inflammatory diseases of the anterior chamber of the eye. Russian Journal of Clinical Ophthalmology. 2025;25(2):79–86 (in Russ.). DOI: 10.32364/2311-7729-2025-25-2-1