Purpose:

Aim of this study was to evaluate the effect of deep anterior lamellar keratoplastyon refraction and visual acuity and its complications in patients who have corneal disease without endothelial or Descemets membrane pathologies.

Matherial and Methods:

This study was performed in twenty two eyes of twenty two patients (11 women, 11 men). The patients had experienced deep anterior lamellar keratoplasty because of different corneal pathologies. Preoperatively best corrected visual acuities were between counting finger from 10 cm. distance to 0.4, refractive errors were -9,00 to -20,00 D (mean 12.25±3.25) spherically, -5,00 to -13,00 D (mean 8.75±2.50) cylendirically. All patients have normal intraocular pressure, preoperatively. Central cornel thickness of the patients were 280-510 micrometer (mean 410±38). Keratometry was mean 55±6.4 D for K1 and 57±6.2 D for K2. In all patients, big bubble technique was tried, when failed manual dissection was applied with blunt spatula. The difference between preoperative and postoperative visual acuity and refraction were compared with Wilcoxon test.

Results:

Patients were followed up mean 22 (5 to 32) months. In all patients postoperative visual acuity was better. Postoperatively best corrected visual acuity (BCVA) was 0,6 or beter in eight patients (%36) at third month, in eleven patients (%50) at sixth month and in sixteen patients (%72) at first year. Postoperative refraction was +7.00 to -6.25 D (mean 5.00± 1.25) spherically; +6,00 to -6,00 D (mean 4.25±0.85) cylendirically (p<0.0001). Keratometric values were 38 to 57 for K1, 42 to 60 for K2. Pachimetry was 480 to 560 micrometer (mean 510±18).

Conclusion:

Because of satisfactory visual and refractive results, lesser complication rates like graft rejection, deep anterior lamellar keratoplasty is a good choise with developed new surgical techniques in patients who have intact corneal endothel and Descemets membrane.

Keywords: Keratoplasty, descemet membrane, endothel, refraction, complication