97th DOG Annual Meeting 1999
INTERMITTENT POSITIVE PRESSURE BREATHING (IPPB) DEVICES TO TREATE SLEEP APNEA ARE A RISK FACTOR FOR PROLONGES WOUND HEALING AFTER OPTIVAL PENETRATING KERATOPLASTY
A. A. Bialasiewicz, K. Engelmann
Background: Postoperative complications by IPPB devices have to our knowledge not been reported as yet.
Patients: Two patients age 40 and 62 years suffered from sleep apnea necessitating IPPB, and ophthalmologically from a keratoglobus and decompensated Fuchs' corneal dystrophy.
Results: In October 1998 the 40 year old patient received an penetrating optical corneal graft OS 7.5x7.7mm. Reepithelialization took 14 days, and a conjunctival hyperemia persisted for almost 3 weeks, until the IPPB device could be disposed of for a few weeks.The 62 year old patient underwent a triple-procedure OD (7.75x8.0mm), and experienced a postoperative reepithelialization of 14 days, and extreme conjunctival hyperemia for 6 weeks. In both patients at no time suture infiltrates or intraocular inflammation had been noted. Bacteriological results of the conjunctiva and smears taken from the devices revealed a daily changing plethora bacteria of the upper respiratory tract (bacillus, pneumococci, hemophilus). The postoperative results 6 months later showed non-irritated grafts with a VA of cc 0.8 resp. cc 0.6.
Conclusions: The use of IPPB devices may result in delayed reepithelialization and persisting conjunctival hyperemia. A temporary disposal of the devices monitored by a pulmologist is necessary in order to achieve good final results.
University Eye Hospital Eppendorf, Martinistr. 52, D-20251 Hamburg