Armagan Ozgur1, Ahmet Yucel Ucgul2, Mehmet Ozgur Cubuk3, Emrah Onat4, Kübra Serbest Ceylanoglu5, Bahri Aydın6, Erdem Yuksel7. 1. Department of Ophthalmology, Cubuk State Hospital, Ankara, Turkey. 2. Department of Ophthalmology, Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Bolu, Turkey. 3. Department of Ophthalmology, Istanbul Training and Research Hospital, Istanbul, Turkey. 4. Department of Electrical and Electronics Engineering, Hacettepe University, Ankara, Turkey. 5. Ulucanlar Eye Training and Research Hospital, Ankara, Turkey. 6. Department of Ophthalmology, Gazi University Medical School, Ankara, Turkey. 7. Department of Ophthalmology, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey. drerdemyuksel@gmail.com.
Abstract
AIMS: To investigate possible predictive topographic characteristics for the development of Descemet's membrane (DM) folds after the uneventful deep anterior lamellar keratoplasty (DALK). METHODS: A retrospective study included 56 eyes of 56 consecutive patients who underwent uneventful DALK using the big-bubble technique to treat advanced keratoconus. At baseline and each visit, best-corrected logMAR visual acuity (BCVA), slit-lamp findings, endothelial cell density, topographic parameters were recorded. DM area is calculated using morphogeometric modelling. RESULTS: Twelve (21.4%) of them exhibited DM folds, whereas the remaining 44 (78.6%) did not exhibit any DM folds after the surgery. The mean follow-up time was 36.3 ± 16.7 (range, 12-71) months. The mean posterior corneal power was - 13.8 ± 0.6 D in patients with DM folds, whereas - 13.0 ± 0.8 D in those without DM folds (p = 0.016). The mean DM area was 53.6 ± 2.3 (50.9-57.9) mm2 in patients with DM folds, whereas 51.6 ± 1.7 (47.1-53.9) mm2 in those without DM folds (p = 0.001). The ROC curve showed that two best cut-off value for the posterior corneal power and DM area were 13.75 D and 53.8 mm2, respectively, to predict the occurrence of DM folds. CONCLUSION: DALK surgery seems to cause DM folds in patients with large DM area and high posterior corneal power.
AIMS: To investigate possible predictive topographic characteristics for the development of Descemet's membrane (DM) folds after the uneventful deep anterior lamellar keratoplasty (DALK). METHODS: A retrospective study included 56 eyes of 56 consecutive patients who underwent uneventful DALK using the big-bubble technique to treat advanced keratoconus. At baseline and each visit, best-corrected logMAR visual acuity (BCVA), slit-lamp findings, endothelial cell density, topographic parameters were recorded. DM area is calculated using morphogeometric modelling. RESULTS: Twelve (21.4%) of them exhibited DM folds, whereas the remaining 44 (78.6%) did not exhibit any DM folds after the surgery. The mean follow-up time was 36.3 ± 16.7 (range, 12-71) months. The mean posterior corneal power was - 13.8 ± 0.6 D in patients with DM folds, whereas - 13.0 ± 0.8 D in those without DM folds (p = 0.016). The mean DM area was 53.6 ± 2.3 (50.9-57.9) mm2 in patients with DM folds, whereas 51.6 ± 1.7 (47.1-53.9) mm2 in those without DM folds (p = 0.001). The ROC curve showed that two best cut-off value for the posterior corneal power and DM area were 13.75 D and 53.8 mm2, respectively, to predict the occurrence of DM folds. CONCLUSION: DALK surgery seems to cause DM folds in patients with large DM area and high posterior corneal power.