A study of anterior chamber morphology using UBM (Ultrasound Biomicroscopy) in cases with corneal pathology undergoing penetrating keratoplasty

Abstract

Introduction/Purpose: Corneal pathologies are one of the leading causes of blindness. Optical rehabilitation for total corneal opacities requires penetrating keratoplasty (PK). It is necessary to understand the associated pathologies of anterior segment before surgery. UBM (Ultrasound biomicroscopy) being the only modality which works on principle of ultrasound waves and can easily peep into the anterior segment via opaque cornea. Method: 37 eyes of 37 patients with corneal opacities due to various reasons that underwent penetrating keratoplasty were evaluated preoperatively by performing UBM in all meridians 360 degrees. Depth and extent of these lesions, thickness of cornea, anterior chamber depth, position, extent and spread of synechiae, fibrous membrane formation and status of lens were noted. Results: 37 patients were grouped into corneal opacities, adherent leucoma and anterior staphylomas. Penetrating keratoplasty was planned along with certain modifications like iris reconstruction, membranectomy, synechiolysis, cataract extraction and IOL implantation or replacement. In 83.33% cases prediction of preoperative UBM findings and surgical modification were found to be accurate. Conclusion: In patients with corneal pathologies, UBM helps to evaluate the morphology of anterior-segment structures and thus in preplanning of surgical strategies and intraoperative modifications.