Original Article

Deep Anterior Lamellar Keratoplasty for Treatment of Keratoconus - Original Article

10.4274/tod.40.171

  • Banu Torun Acar
  • Didem Esen
  • Bülent İ. Buttanrı
  • Şahin M. Sevim

Received Date: 09.12.2009 Accepted Date: 23.03.2010 Turk J Ophthalmol 2010;40(3):171-175

Purpose:

To evaluate the results and complications of deep anterior lamellar keratoplasty for treatment of keratoconus.

Material and Method:

Forty eyes of 40 patients with keratoconus were included in this study. In all patients, big-bubble technique was tried in order to perform deep anterior lamellar keratoplasty; when failed, manual dissection was applied. Pre- and postoperative best-corrected visual acuity, refractive results, surgical technique and complications were analyzed.

Results:

40 patients, 18 females and 22 males, with a mean age of 24.02±6.20 years (range, 15-36 years) were included in the study; the mean follow-up period was 14.92±2.39 months (range, 10-18 months). The mean postoperative refraction was -3.29±1.46D (+2.00 to -5.50D) spherically, and -4.24±0.72D (-2.50 to -5.50D) cylindrically (p<0.05). Keratometric values were 45.16±2.84D (37.30-50.89D) SimK1, and 48.50±2.78D (40.42-53.85D) SimK2. The mean postoperative pachymetry was 558.64±22.02 µm (514-614 µm) and the mean endothelial cell density was 2369.52±265.59 cell/mm2. Intraoperative microperforation of Descemet’s membrane occurred in 6 patients. In postoperative follow-up period, double anterior chamber developed in 3 eyes, epithelial defects were seen in 26 eyes, foreign bodies were detected in the graft-bed interface in 10 eyes, and suture abscess in 2 eyes. There was no endothelial rejection.

Discussion:

Deep anterior lamellar keratoplasty is safe and effective surgical technique in patients with keratoconus. Visual outcome is comparable to standard penetrating keratoplasty, without the risk of endothelial rejection.

Keywords: Keratoconus, deep anterior lamellar keratoplasty, Descemet’s membrane

Full Text (Turkish)