Comparison of Descemet-On Versus Descemet-Off Deep Anterior Lamellar Keratoplasty in Keratoconus Patients

Prazeres, Tatiana Moura Bastos; Müller, Rodrigo; Rayes, Tatiana Rocha; Hirai, Flávio E.; Sousa, L.B.

doi:10.1097/ico.0000000000000444

Cited by 12 publications

(4 citation statements)

References 29 publications

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“…A recently conducted clinical trial comparing visual outcomes in patients undergoing DALK with and without removal of the donor DM and endothelium had results similar to ours (22) . We understand that the retrospective, non-comparative nature of this study has limitations.…”

Section: Discussionsupporting

confidence: 52%

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Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium

Prazeres¹,

Müller²,

Rayes³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Approved by the following research ethics committee: Hospital Oftalmológico de Sorocaba (# 1.326.225). RESUMO ABSTRACTPurpose: The optical quality of the interface after deep anterior lamellar keratoplasty (DALK) using the big-bubble technique has been shown to be excellent, leading to results comparable to penetrating keratoplasty. However, there is little in the literature with respect to the controversy surrounding the preparation of the donor cornea. The purpose of this study was to evaluate visual acuity (VA) in patients with keratoconus who underwent DALK without removal of the donor graft endothelium. Methods: The records of 90 patients who underwent DALK without the removal of the Descemet membrane (DM) and endothelium were retrospectively reviewed. Data collected included uncorrected VA (UCVA) and spectacle-corrected VA (SCVA) at 7, 30, 180 days, and 1 year postoperatively. Contact lens-corrected visual acuity (CLVA) was evaluated after 1 year of the procedure. Results: UCVA was significantly better than preoperative values at 7 days (p<0.001), 30 days (p<0.001), 180 days (p<0.001), and 1 year (p<0.001) after surgery. The 1-year postoperative mean SCVA and CLVA also improved when compared with preoperative SCVA (p<0.001 for both). Conclusions: DALK utilizing donor corneas with attached Descemet membrane and endothelium results in satisfactory VA in patients with keratoconus.

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Section: Discussionsupporting

confidence: 52%

“…Comparative studies found no significant differences after DALK in VA and contrast sensibility, irrespective of whether the donor endothelium was removed or left attached (20)(21)(22)(23) . The present study aimed to evaluate visual outcomes in patients with keratoconus undergoing DALK using full-thickness donor endothelial grafts.…”

Section: Introductionmentioning

confidence: 99%

Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium

Prazeres¹,

Müller²,

Rayes³

et al. 2016

Arquivos Brasileiros De Oftalmologia

Self Cite

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“…Also, if an early detachment occurs (on the first or second postoperative day) due to a surgical perforation, which does not have a good response to rebubble, it is common for the button to remain transparent. In addition, there are studies that show no significant advantage in removing the DM from the donor (11, 12).…”

Section: Discussionmentioning

confidence: 99%

Late Detachment after DALK in a Patient with Descemet Membrane Microperforation

Passos

Ghanem

Piccinini

et al. 2017

Ophthalmology @ Point of Care

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We report a case of late detachment in a patient with Descemet membrane (DM) microperforation following a deep anterior lamellar keratoplasty (DALK). Late detachment of the DM in this case occurred 5 months after DALK because of the flattening pressure during the retinal exam with scleral depression. In patients with a history of microperforation during DALK, we suggest that the retinologist and patient avoid rubbing or applying pressure over the eye to minimize the risk of late detachment of the DM.

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“…It is with great interest that we read the article published by Prazeres et al 1 The authors prospectively compared the outcome of Descemet's membrane-on with Descemet's membrane-off deep anterior lamellar keratoplasty in patients with keratoconus.…”

Section: To the Editormentioning

confidence: 99%