AC/PC Intraocular Lens Exchange with Penetrating Keratoplasty in Pseudophakic Bullous Keratopathy

Background

Evaluation of penetrating keratoplasty in cases of pseudophakic bullous keratopathy with AC/PC IOL exchange.

Methods

This retrospective study included 120 cases of pseudophakic bullous keratopathy managed over 9 years at three tertiary care eye centres followed up for 4 years. Cases were taken up for penetrating keratoplasty along within adjuvant procedures like IOL explantation and Secondary Posterior Chamber IOL implantation over the frill of posterior capsule.

Results

Lens exchange with Penetrating Keratoplasty (PK) was done in 93 and PK without lens exchange in 27 cases. 25% required systemic steroids for 2-3 weeks. Re-grafting was performed in 5% and 85% attained moderate visual acuity.

Conclusion

Intra ocular lens exchange and Posterior chamber IOL are suitable for penetrating keratoplasty in terms of optical clarity, graft survival and visual outcome.Key Words: PBK, IOL exchange (AC/PC)     

Possible indirect binding of IgE in house dust RAST.

House dust subfractions obtained in the course of purification exhibit increasing skin reactivity in allergic patients, which runs parrallel to both complement-consuming and RAST-binding capacity. Working with highly purified house dust allergen in RAST, the correlation with clinical parameters for house dust allergy was found to remain poor. In a large group of sera a significant statistical correlation was found between total IgE and allergen-binding IgE. Ultracentrifugation experiments demonstrated that IgE binding to allergen in RAST occurs in complex with an unidentified serum protein. These results suggests that IgE binding in house dust RAST is indirect and is mediated by another serum factor.