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Complications and Management of Deep Anterior Lamellar Keratoplasty
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Original Article
VOLUME: 44 ISSUE: 5
P: 337-340
October 2014

Complications and Management of Deep Anterior Lamellar Keratoplasty

Turk J Ophthalmol 2014;44(5):337-340
DOI: 10.4274/tjo.02259
Banu Torun Acar 1
Tahir Kansu Bozkurt 2
Selin Tuğtan 3
Suphi Acar 4
1. Haydarpasa Numune Egitim Ve Arastirma Hastanesi, Göz Hastaliklari Klinigi, Istanbul, Türkiye
2. Ümraniye Egitim Ve Arastirma Hastanesi, Göz Hastaliklari Klinigi, Istanbul, Türkiye
3. Afyon Devlet Hastanesi, Göz Hastaliklari Klinigi, Afyon, Türkiye
4. Serbest Hekim
No information available.
No information available
Received Date: 10.12.2013
Accepted Date: 24.04.2014
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ABSTRACT

Objectives:

To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK) surgery.

Materials and Methods:

Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated.

Results:

Big bubble was created in 220 (77.5%) eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5%) eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK). Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC) occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed.

Conclusion:

DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery.