CORNEAL PROTECTION ACCORDING TO PUTSCHKOWSKAJA

Background Excessive cornea defects after chemical, thermal and microbiological damages respectively trophic disturbances often demand measures for conservation of the bulbus. Patients and methods In the time between 1969 and 1993 22 patients were provided with a ''Keratoplasty according to Putschkowskaja'': circular cut at the recipient eye 0,15 mm deep, trepan diameter 8,5 to 13 mm, without lamellar preparation, covering with a donor cornea of normal thickness by silk single sutures. Results In 19 eyes the primary aim, the conservation of the bulbus, could be achieved. The complete transplant was mostly rejected after several months, only in two patients it healed by vascularisation. In one patient an abscess arose between recipient - cornea and transplant, which made explantation necessary. The histological examination of the transplant showed a purulent inflammation, swelling of the parenchym, partly absence of keratocytes and endothel cells, and a defect in the Bowman membrane. Conclusion The ''Keratoplasty according to Putschkowskaja'' can be useful as ''living contact lens'' besides other surgical measures for treatment (primary conservation of the bulbus) of excessive cornea defects. It seems that the existence of Bowman and Descemet membrane in the transplant prevents the decomposition of the donor cornea for a rather long time. By then the cornea defect has often healed leaving scars.