scholarly journals The ABCD of DALK

2017 ◽  
Vol 10 (02) ◽  
pp. 93
Author(s):  
Jod Mehta ◽  
Keyword(s):  
Corneal Transplantation ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Anterior Lamellar Keratoplasty

Corneal transplantation has changed rapidly over the last 20 years. In spite of the fact that endothelial keratoplasty has become the most dominant procedure, deep anterior lamellar keratoplasty (DALK), the anterior lamellar procedure, has not become so popular. There are several reasons for this, and this editorial will attempt to give some useful tips, that may not be found in papers or books, in the hope of helping people performing or starting off on their DALK journey.

Corneal transplantation trends in France from 2004 to 2015: A 12-year review

2018 ◽  
Vol 28 (5) ◽  
pp. 535-540 ◽  
Author(s):  
Guillaume Bigan ◽  
Marc Puyraveau ◽  
Maher Saleh ◽  
Philippe Gain ◽  
Isabelle Martinache ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Dystrophy ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Surgical Indications ◽  
Anterior Lamellar Keratoplasty ◽  
Important Shift

Purpose: The aim of this study was to report the 12-year longitudinal trends in indication and corneal transplantation techniques in France from 2004 to 2015. Results: The records of all corneal transplantations performed from 2004 to 2015 in France were retrospectively reviewed. The patient indications and types of transplant performed were analyzed. A total of 46,658 corneal transplantations were performed between 2004 and 2015, with 34,187 (73.3%) penetrating keratoplasty and 10,452 (22.4%) lamellar keratoplasty. The leading surgical indications were secondary endothelial failure (24.3%), keratoconus (18.8%), regraft (13.5%), and Fuchs endothelial corneal dystrophy (15.1%). Endothelial keratoplasty became the preferred technique for endothelial diseases and deep anterior lamellar keratoplasty the preferred technique for keratoconus, surpassing penetrating keratoplasty in 2013. Conclusion: Secondary endothelial failure is the top indication for performing a keratoplasty over the 12-year period. There was a shift from penetrating keratoplasty to endothelial keratoplasty performed for Fuchs endothelial corneal dystrophy and secondary endothelial failure, and to deep anterior lamellar keratoplasty, performed for keratoconus. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.

scholarly journals Intraoperative Optical Coherence Tomography Imaging in Corneal Surgery: A Literature Review and Proposal of Novel Applications

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Hiroshi Eguchi ◽  
Fumika Hotta ◽  
Shunji Kusaka ◽  
Yoshikazu Shimomura
Keyword(s):  
Optical Coherence Tomography ◽  
Corneal Transplantation ◽  
Anterior Segment ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Endothelial Keratoplasty ◽  
Corneal Surgery ◽  
Anterior Lamellar Keratoplasty ◽  
Intraoperative Optical Coherence Tomography

Intraoperative optical coherence tomography (iOCT) is widely used in ophthalmic surgeries for cross-sectional imaging of ocular tissues. The greatest advantage of iOCT is its adjunct diagnostic efficacy, which facilitates to decision-making during surgery. Since the development of microscopic-integrated iOCT (MIOCT), it has been widely used mainly for vitreoretinal and anterior segment surgeries. In corneal transplantation, MIOCT allows surgeons to visualise structure underneath the turbid and distorted cornea, which are impossible to visualise with a usual microscope. Real-time visualisation of hard-to-see area reduces the operation time and leads to favorable surgical outcomes. The use of MIOCT is advantageous for a variety of corneal surgical procedures. Here, we have reviewed articles focusing on the utility of iOCT  and MIOCT in penetrating keratoplasty, deep anterior lamellar keratoplasty, Descemet stripping automated endothelial keratoplasty, and Descemet membrane endothelial keratoplasty. The applications of MIOCT to corneal surgery in terms of surgical education for trainees, emergency surgery, and novel surgery are also discussed, with our cases performed using RESCAN® 700.

scholarly journals Approaches toward enhancing survival probability following deep anterior lamellar keratoplasty

2020 ◽  
Vol 12 ◽  
pp. 251584142091301
Author(s):  
Sepehr Feizi ◽  
Amir A Azari
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Corneal Transplantation ◽  
Corneal Neovascularization ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Vernal Keratoconjunctivitis ◽  
Full Thickness ◽  
Appropriate Treatment ◽  
Anterior Lamellar Keratoplasty

The greatest advantage of deep anterior lamellar keratoplasty over full-thickness corneal transplantation is the elimination of graft failure caused by endothelial rejection. Despite this advantage, a deep anterior lamellar keratoplasty graft can fail because of several factors, such as complications related to the donor–recipient interface, graft epithelial abnormalities, graft vascularization, stromal graft rejection, and recurrence of herpetic keratitis. Increased deep anterior lamellar keratoplasty graft survival is mainly built upon optimization of the ocular surface to provide a hospitable environment for the graft. Any predisposing factors for graft epithelial abnormalities, corneal neovascularization, and preexisting vernal keratoconjunctivitis should be identified and treated preoperatively. Prompt recognition and appropriate treatment of interface-related complications and stromal graft rejection usually result in good anatomic outcomes, with no detrimental effects on vision.

scholarly journals Recurrent Keratoconus

2013 ◽  
Vol 2 (2) ◽  
pp. 65-68
Keyword(s):  
Penetrating Keratoplasty ◽  
Treatment Options ◽  
Corneal Transplantation ◽  
Wound Dehiscence ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Time To Recurrence ◽  
Anterior Lamellar Keratoplasty ◽  
Corneal Thinning ◽  
Corneal Disorder

Abstract Keratoconus is an ectatic corneal disorder characterized by progressive corneal thinning and protrusion. Keratoconus recurrence after corneal transplantation although rare is present and has been confirmed histologically. Host, donor, genetic, mechanical and environmental factors have been proposed as predisposing factors to initiate keratoconus recurrence. The time-to-recurrence post-deep anterior lamellar keratoplasty seems to occur earlier than after penetrating keratoplasty. Wound dehiscence and high astigmatism post-transplant are plausible differential diagnosis for this entity. The treatment options are similar to primary keratoconus. Since, the era of collagen corneal cross-linking, early diagnosis is desirable as it could halt the progression of recurrent keratoconus. How to cite this article Barbara R, Barbara A. Recurrent Keratoconus. Int J Kerat Ect Cor Dis 2013;2(2):65-68.

Descemet Membrane Endothelial Keratoplasty for Failed Deep Anterior Lamellar Keratoplasty

Cornea ◽  
2018 ◽  
Vol 37 (6) ◽  
pp. 682-686 ◽  
Author(s):  
Adi Einan-Lifshitz ◽  
Nir Sorkin ◽  
Tanguy Boutin ◽  
Zale Mednick ◽  
Mohammad Kreimei ◽  
...  
Keyword(s):  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty
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