Gamma-irradiated corneas for therapeutic penetrating keratoplasty, anterior lamellar keratoplasty, and sclera for glaucoma valve surgery

Abstract

Objectives: To report clinical outcomes of gamma-irradiated donor cornea (GIDC) for therapeutic penetrating keratoplasty (TPK), deep anterior lamellar keratoplasty (DALK) and gamma-irradiated donor sclera (GIDS) for glaucoma patch graft (GPG) in glaucoma filtering surgery (GFS) with Ahmed glaucoma valve (AGV). Materials and Methods: A prospective non-randomized, non-comparative, interventional case series of GIDC and GIDS involving 26 patients, of which 20 received GIDC (11 TPK, 9 DALK) and 6 GIDS (6 GPG). Main outcome measures were post-operative tissue characteristics as epithelialization and tissue clarity; and complications including rejection, infection, corneal melt, and other adverse effects. Results: Study included 26 patients, of these 20 received GIDC (11 TPK, 9 DALK) and 6 GIDS (6 GPG). Mean follow up was 8.32 ± 2.31 months. Corneal epithelium healed in 6.2 ± 2.58 days. Graft clarity was achieved in 9 (100%) DALK patients. Only 1 eye (3.8%) had a corneal melt. There were no incidences of rejection or infection in the follow up time. Conclusion: Gamma-irradiated sterilization of donor cornea and sclera is a new innovation to enhance utilization of donor tissue. GIDC is a promising treatment option for TPK and DALK; GIDS for GPG with good epithelialization time and tissue clarity. Gamma irradiation of both donor cornea and sclera achieved adequate sterilization and provided a long shelf life.