AIM: To compare visual outcomes between deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK). Secondarily to compare refractive outcomes, complications and graft survival between the three cohorts. METHODS: Retrospective case-control study evaluating visual acuity outcomes (VA) following DALK with complete Descemet's baring (DALKa) (modified Anwar big bubble technique--51 eyes), pre-descemetic anterior lamellar keratoplasty (DALKm) (manual technique--52 eyes) and PK (103 eyes) with mean follow-up of 13.6, 19.3 and 18.6 months, respectively. RESULTS: The common indications for surgery were corneal scars (36.4%), keratoconus (28.6%) and corneal dystrophies (13.6%). A best-corrected VA of 6/7.5 or better was achieved in 19.4% (PK), 21.6% (DALKm) and 38.5% (DALKa) of cases (p=0.02), and eyes that underwent DALKa had significantly better visual outcomes than PK (p=0.03). Complications following PK were glaucoma (15%), endothelial rejection (12%) and epithelial problems (11%); in the lamellar group, glaucoma (9%), epithelial problems (5%) and Descemet's detachment (3%) were more common. The 2-year estimated probability of graft survival was 90% for PK, 98% for DALKm and 100.0% for DALKa (p=0.35). CONCLUSIONS: Lamellar keratoplasty with complete baring of the Descemet's membrane (DALKa) gave significantly better visual outcomes compared to PK or pre-descemetic ALK and should be the preferred from of corneal replacement in corneal disorders with healthy endothelium.
AIM: To compare visual outcomes between deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK). Secondarily to compare refractive outcomes, complications and graft survival between the three cohorts. METHODS: Retrospective case-control study evaluating visual acuity outcomes (VA) following DALK with complete Descemet's baring (DALKa) (modified Anwar big bubble technique--51 eyes), pre-descemetic anterior lamellar keratoplasty (DALKm) (manual technique--52 eyes) and PK (103 eyes) with mean follow-up of 13.6, 19.3 and 18.6 months, respectively. RESULTS: The common indications for surgery were corneal scars (36.4%), keratoconus (28.6%) and corneal dystrophies (13.6%). A best-corrected VA of 6/7.5 or better was achieved in 19.4% (PK), 21.6% (DALKm) and 38.5% (DALKa) of cases (p=0.02), and eyes that underwent DALKa had significantly better visual outcomes than PK (p=0.03). Complications following PK were glaucoma (15%), endothelial rejection (12%) and epithelial problems (11%); in the lamellar group, glaucoma (9%), epithelial problems (5%) and Descemet's detachment (3%) were more common. The 2-year estimated probability of graft survival was 90% for PK, 98% for DALKm and 100.0% for DALKa (p=0.35). CONCLUSIONS:Lamellar keratoplasty with complete baring of the Descemet's membrane (DALKa) gave significantly better visual outcomes compared to PK or pre-descemetic ALK and should be the preferred from of corneal replacement in corneal disorders with healthy endothelium.
Authors: Paramjit K Bhullar; Oscar M Carrasco-Zevallos; Alexandria Dandridge; Neel D Pasricha; Brenton Keller; Liangbo Shen; Joseph A Izatt; Cynthia A Toth; Anthony N Kuo Journal: Asia Pac J Ophthalmol (Phila) Date: 2017 Sep-Oct
Authors: Neel D Pasricha; Christine Shieh; Oscar M Carrasco-Zevallos; Brenton Keller; David Cunefare; Jodhbir S Mehta; Sina Farsiu; Joseph A Izatt; Cynthia A Toth; Anthony N Kuo Journal: Cornea Date: 2016-11 Impact factor: 2.651
Authors: Zarique Z Akanda; Abdul Naeem; Elizabeth Russell; Jillian Belrose; Francie F Si; William G Hodge Journal: PLoS One Date: 2015-03-17 Impact factor: 3.240