scholarly journals Quality of Vision after Deep Anterior Lamellar Keratoplasty (Fluid Dissection) Compared to Penetrating Keratoplasty for the Treatment of Keratoconus

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Islam Mahmoud Hamdi ◽  
Momen Mahmoud Hamdi
Keyword(s):  
Penetrating Keratoplasty ◽  
Complete Removal ◽  
Quality Parameters ◽  
Optical Quality ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Modulation Transfer ◽  
Cross Sectional ◽  
Anterior Lamellar Keratoplasty

Purpose. To compare the visual quality of patients with keratoconus who underwent penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK) with fluid dissection. Design. Cross-sectional, observational study. Methods. Twelve eyes that underwent PKP (PKP group) were compared to 24 eyes that underwent DALK (DALK group) after complete removal of sutures and stability of refraction. Visual, refractive, corneal topographic, corneal aberrometry, and ocular aberrometry parameters were compared for both groups. The χ2 and Mann–Whitney U tests were used for comparisons as appropriate. P<0.05 was considered statistically significant. Results. Uncorrected and best spectacle-corrected visual acuity (UCVA and BSCVA, resp.), mean refractive spherical equivalent and mean refractive cylinder (MRSE and MRC, resp.), root mean square of the 3 mm and 5 mm OPD Scan (NIDEK Co. Ltd., Gamagori, Japan), steep and flat meridians (SimK1 and SimK2, resp.), and the difference (corneal cylinder) were not statistically significantly different between groups (P>0.05, all comparisons). All aberrations, point spread functions (PSF), and the modulation transfer function (MTF) were not statistically different between groups (P>0.05). Conclusion. For our small study, the postoperative PKP and DALK with fluid dissection patient groups had vision/optical quality parameters that were not statistically different. This may indicate that DALK with fluid dissection can replace PKP for keratoconus without compromising vision quality.

scholarly journals Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus

2021 ◽  
Vol 10 (11) ◽  
pp. 2421
Author(s):  
Dominika Janiszewska-Bil ◽  
Barbara Czarnota-Nowakowska ◽  
Katarzyna Krysik ◽  
Anita Lyssek-Boroń ◽  
Dariusz Dobrowolski ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Adverse Events ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Cell Loss ◽  
Anterior Lamellar Keratoplasty ◽  
Significant Difference

We compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52). This is a prospective, comparative cohort study of 90 eyes (90 patients) with a clinical diagnosis of keratoconus. Patients underwent a complete eye examination before the surgical approach, 6 and 12 months postoperatively that consisted of BCVA, refractive astigmatism (AS), central corneal thickness (CCT), IOP, and ECL. Secondary outcomes were adverse events related to the surgical procedure. With lower ECL and less adverse events, DALK was revealed to be beneficial over PK with similar visual outcomes. Results: There was no significant difference between the BCVA in the DALK and PK groups (at 6 months: 0.49 ± 0.17 vs. 0.48 ± 0.17; p = 0.48; at 12 months: 0.54 ± 0.17 vs. 0.52 ± 0.14; p = 0.41). The mean value of AS was significantly lower after the PK procedure when compared to DALK, after both 6 and 12 months of follow up (p < 0.001). The CCT in the DALK group was significantly lower when compared to the PK group (at 6 months: 452.1 ± 89.1 µm vs. 528.9 ± 69.9 µm, p < 0.0001; at 12 months: 451.6 ± 83.5 µm vs. 525.5 ± 37.1 µm). The endothelial cell loss at 12 months after surgery was significantly lower after DALK when compared to PK (p < 0.0001). DALK transplantation should be considered as an alternative procedure in the surgical treatment of keratoconus.

Penetrating keratoplasty versus deep anterior lamellar keratoplasty in children and adolescents with keratoconus

2021 ◽  
Author(s):  
Sepehr Feizi ◽  
Mohammad Ali Javadi ◽  
Mohammad Abolhosseini ◽  
Seyed-Mohamadmehdi Moshtaghion ◽  
Ali Naderi ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Penetrating Keratoplasty ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty

Deep Anterior Lamellar Keratoplasty as an Alternative to Penetrating Keratoplasty

Ophthalmology ◽  
2011 ◽  
Vol 118 (1) ◽  
pp. 209-218 ◽  
Author(s):  
William J. Reinhart ◽  
David C. Musch ◽  
Deborah S. Jacobs ◽  
W. Barry Lee ◽  
Stephen C. Kaufman ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty

scholarly journals Comparison of penetrating keratoplasty and deep anterior lamellar keratoplasty in keratoconus eyes with vernal keratoconjunctivitis

2021 ◽  
Vol 13 ◽  
pp. 251584142110105
Author(s):  
Sepehr Feizi ◽  
Mohammad Ali Javadi ◽  
Seyed-Mohamadmehdi Moshtaghion ◽  
Mohammad Abolhosseini
Keyword(s):  
Penetrating Keratoplasty ◽  
Survival Curve ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Vernal Keratoconjunctivitis ◽  
Anterior Lamellar Keratoplasty ◽  
Disease Reactivation ◽  
Group 2 ◽  
Group 1

Purpose: The purpose of the study is to compare outcomes after penetrating keratoplasty (PK) against deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC). Methods: Keratoconic patients with VKC who received PK ( n = 55, group 1) or DALK ( n = 62, group 2) were retrospectively enrolled. The Student’s t test, Mann–Whitney test, Fisher’s exact test, chi-square test, and Kaplan–Meier survival curve were used to compare outcomes between the groups. Results: The follow-up period was 59.4 ± 44.1 and 62.4 ± 38.9 months in groups 1 and 2, respectively ( p = 0.70). Postoperative best spectacle-corrected visual acuity was 0.24 ± 0.18 and 0.29 ± 0.19 logMAR, respectively ( p = 0.13). Graft rejection occurred in 34.6% and 25.8% of eyes in groups 1 and 2, respectively ( p = 0.30). Groups 1 and 2 were comparable in the rates of cataract (3.6% and 12.9%, respectively, p = 0.07) and high intraocular pressure (3.6% and 8.1%, respectively, p = 0.31). Compared with the eyes with inactive VKC, PK eyes that experienced postoperative disease reactivation had a higher rate of suture abscesses (10.9% versus 50.0%, respectively, p = 0.01) and suture-tract vascularization (6.5% versus 33.3%, respectively, p = 0.03). Similarly, disease reactivation significantly increased suture abscesses from 27.3% to 51.7% ( p = 0.03) and suture-tract vascularization from 18.2% to 49.6% ( p = 0.005) in the DALK group. The graft survival rates were 95.3% in group 1 and 87.9% in group 2 at the 4-year follow-up, with mean durations of 14.4 and 11.1 months, respectively ( p = 0.20). Conclusion: The results indicate no difference in outcomes between PK and DALK for keratoconus in patients with VKC. Postoperative VKC reactivation increased the rate of suture-related problems after both techniques of keratoplasty.

Economic Evaluation of Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty in The Netherlands

2011 ◽  
Vol 151 (3) ◽  
pp. 449-459.e2 ◽  
Author(s):  
Frank J.H.M. van den Biggelaar ◽  
Yanny Y.Y. Cheng ◽  
Rudy M.M.A. Nuijts ◽  
Jan S. Schouten ◽  
Robert-Jan Wijdh ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
The Netherlands ◽  
Penetrating Keratoplasty ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty
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