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Cornea. 2009 Jun;28(5):489-92. doi: 10.1097/ICO.0b013e31818d3b3c.

Deep anterior lamellar keratoplasty over penetrating keratoplasty for host rim thinning and ectasia.

Author information

1
Corneo Plastic Unit & Eye Bank, Queen Victoria Hospital NHS Trust, West Sussex, United Kingdom.

Abstract

PURPOSES:

To describe the technique and evaluate the outcomes of patients who had deep anterior lamellar keratoplasty (DALK) for ectasia within or outside the graft-host interface in a previous penetrating keratoplasty (PK).

DESIGN:

Retrospective review of interventional case series.

PATIENTS:

Seven eyes that underwent DALK for corneal ectasia after previous PK.

INTERVENTION:

DALK encompassing the area of ectasia and the previous PK.

MAIN OUTCOME MEASURES:

Uncorrected visual acuity, best spectacle-corrected visual acuity, keratometry and topography, and complications.

RESULTS:

Seven eyes had DALK, 4 developed Descemet membrane tears, and 2 eyes had deep graft-host dehiscence from the previous PK intraoperatively. At 12 months, mean uncorrected visual acuity (logarithm of the minimum angle of resolution) improved from 1.157 to 0.74. Mean best spectacle-corrected visual acuity improved from 0.82 to 0.37 at 12 months.

CONCLUSIONS:

DALK can be successfully performed over a previous PK. Intraoperative Descemet tears or dehiscence of Descemet at the previous graft-host interface can complicate surgery, but if successfully managed can produce a significant improvement in visual acuity.

PMID:
19421052
DOI:
10.1097/ICO.0b013e31818d3b3c
[Indexed for MEDLINE]

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