Our Anesthetic Experiences in Patients Undergoing Corneal Transplantation

Abstract

Objective: Corneal transplantation (keratoplasty) is one of the most common forms of human donor transplantation. In addition to the surgical technique and other factors, anesthesia management during surgery is also important. In this study, we evaluated our anesthesia management in patients who underwent corneal transplantation surgery in our hospital. Materials and Method: After ethics committee approval is received, the files of patients who underwent corneal transplantation between 01-09.2023 and 01.12.2024 were retrospectively reviewed. The demographic findings of the patients, comorbidities, anesthesia methods applied, operation times, hospital stays, mortality and complications were evaluated. Results: 30 patients participated in the study. 17 of the patients were female and 13 were male, the mean age was 58.6 ±17.77. 56.7% of the patients were in the American Society of Anesthesiologists (ASA) II class, 30% were in the ASA III, and 13.3% were in the ASA I risk group. 63.3% of the patients had additional diseases. The mean surgery time was 83.33±22.75 minutes, and the median hospital stay was 1 (1-8) days. Conclusion: To achieve optimal results in corneal transplants, a multidisciplinary approach is required for anesthesia management, especially in patient groups with comorbidities.

Keywords

• Corneal Transplantation
• Anesthesia
• Multidisciplinary approach

Kornea Nakli Uygulanan Hastalardaki Anestezik Deneyimlerimiz

Abstract

Amaç: Tam kat kornea nakli (penetran keratoplasti) Dünya’da en çok uygulanan doku nakli olarak ön plana çıkmaktadır. Uygulanan ameliyat tekniği ve diğer faktörlerin yanında ameliyat sırasındaki anestezi yönetimi de önemlidir. Bu çalışma da hastanemizde kornea nakil operasyonu uygulanan hastalardaki anestezi yönetimimizi değerlendirdik. Materyal ve Metot: Etik kurulu onayı alındıktan sonra kornea nakli nedeniyle 01-09.2023 ve 01.12.2024 tarihleri arasında opere edilen hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik bulguları, komorbiditeleri, uygulanan anestezi yöntemleri, operasyon süreleri, hastanede kalış süreleri, mortalite ve komplikasyonlar değerlendirildi. Bulgular: Çalışmaya 30 hasta katıldı. Hastaların 17’si kadın, 13’ü erkekti, yaş ortalamaları 58,6 ±17,77 idi. Hastaların %56,7’si American Society of Anesthesiologists (ASA) II sınıfındayken %30’u ASA III, ve %13,3’ü ASA I risk grubundaydı. Hastaların %63,3’ün de ek hastalık mevcuttu. Ortalama ameliyat süreleri 83,33±22,75 dakika, hastane kalış süre ortancaları 1(1-8) gündü. Sonuç: Kornea nakillerinde optimal sonuçların elde edilmesi için özellikle komorbiditesi olan hasta gruplarında anestezi yönetimi multidisipliner bir yaklaşım gerektirmektedir.

Keywords

• Kornea nakli
• Anestezi
• Multidisipliner yaklaşım

References

1. Anshu A, Li L, Htoon HM, Benito-Llopis L, Shuang LS, Singh MJ, et al. Long-term review of penetrating keratoplasty: A 20-year review in asian eyes. Am J Ophthalmol. 2021;Apr (224):254-266.
2. Bayraktar Ş, Cudri N. Care Management of Patients with Corneal Transplantation. In: Özbaş A, editor. Organ Transplantations and Nursing Care. 1st edition. Ankara: Türkiye Klinikleri; 2021. p.67-73.
3. Ersun B. Anesthesia in ophthalmology surgery . In: Işık B, translation editor. Morgan & Michail Clinic Anesthesiology. 7.th edition, Güneş tıp Kitabevi, 2024, p;777-791.
4. Kelly DJ, Farrell SM. Physiology and role of intraocular pressure in contemporary anesthesia. Anesth Analg 2018; 126 (5):1551-1552.
5. Krysik K, Wroblewska-Czajka E, Lyssek-Boron A, Wylegala EA, Dobrowolski D. Total penetrating keratoplasty: Indications, therapeutic approach, and long-term follow-up. J Ophthalmol. 2018 Apr 19;2018:9580292.
6. Nurözler Tabakcı B. Historical evoluation and types of cornea transplantation.. In: Burcu A, editor. Innovations in cornea transplantation. 1st edition. Ankara: Türkiyr Klinikleri; 2021. p.1-5.
7. Qureshi S, Dohlman TH. Penetrating keratoplasty: Indications and graft survival by geographic region. Semin Ophthalmol. 2023 Jan;38(1):31-43.
8. Shimmura-Tomita M, Shimmura S, Tsubota K, Shimazaki J. Penetrating keratoplasty performed by residents compared with an experienced cornea transplant surgeon. J Surg Educ. 2017:74(2):258-263.

9. Singh RB, Khera T, Ly V, Saini C, Cho W, Shergill S et al., Ocular complications of perioperative anesthesia: a review. Graefes Arch Clin Exp Ophthalmol, 2021;259 (8):2069-2083.
10. Wang X, Dang GF, Li YM, Li WF, Wu XY. General anesthesia versus local anesthesia for penetrating keratoplasty :a prospective study. Int J Ophthalmol. 2014;7(2):278-282
11. Yadav S, Jahagirdar A, Jamwal P, Mishra J, Thind GBS, Shashank C, et al. Retrospective Study of Anesthesia-Related Complications in Elderly Patients Undergoing Surgery. J Pharm Bioallied Sci. 2024;16 (Supp 3):S2572-5.