Deep anterior lamellar keratoplasty outcomes in macular and granular corneal dystrophy – A comparative cross-sectional study

Kodavoor, Shreesha Kumar; Deb, Bijita; Dandapani, Ramamurthy

doi:10.4103/ijo.ijo_1623_18

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…A comparative study was conducted by Kodavoor SK et al . [ 28 ] between the outcomes of macular and granular corneal dystrophy, which concluded comparable results.…”

Section: Discussionmentioning

confidence: 79%

Complications in deep anterior lamellar keratoplasty – A retrospective interventional analysis in a large series

Kodavoor

Rathi

Dandapani

2022

Indian Journal of Ophthalmology

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Purpose: To analyze the complications in patients managed with deep anterior lamellar keratoplasty (DALK) for diseases of the anterior corneal stroma. Methods: This is a retrospective analysis of all the patients who underwent DALK in a tertiary care center in South India from 2010 to 2020. A total of 474 eyes in 373 patients were included in the study. Patients who underwent DALK for advanced keratoconus, keratoconus with Bowman’s membrane scar, healed hydrops, macular corneal opacity, macular corneal dystrophy, granular corneal dystrophy, spheroidal degeneration, pellucid marginal degeneration, post–laser-assisted in situ keratomileusis ectasia, descematocele, post-collagen cross-linking aborted melt and dense scar, and post-radial keratotomy were included in the study. The patients were followed up for 17.2 +/- 9.2 months (1–9 years). Results: Complications noted in the surgery were intra-operatively Descemet’s membrane perforation in 31 eyes (6.54%), post-operatively secondary glaucoma in 16 eyes (3.37%), cataract in seven eyes (1.47%), suture-related complications in five eyes (1.05%), graft rejection in three eyes (0.63%), traumatic dehiscence in two eyes (0.42%), filamentary keratitis in two eyes (0.42%), interface infiltrate in one eye (0.21%), and recurrence of disease in four eyes (7.14%) out of 57 eyes with corneal dystrophy. Conclusion: DALK as an alternative to penetrating keratoplasty for anterior corneal stromal diseases. It has become an automatic choice for diseases of the anterior cornea requiring keratoplasty. Complications can occur at any stage of surgery; however, if identified and managed early, they can result in optimal outcome.

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“…A comparative study was conducted by Kodavoor SK et al . [ 28 ] between the outcomes of macular and granular corneal dystrophy, which concluded comparable results.…”

Section: Discussionmentioning

confidence: 79%

Complications in deep anterior lamellar keratoplasty – A retrospective interventional analysis in a large series

Kodavoor

Rathi

Dandapani

2022

Indian Journal of Ophthalmology

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“…The choice of transplantation method for MCD depends on the severity of the patient's condition. While both DALK and PK have demonstrated successful outcomes in the past, there have been concerns regarding lamellar surgery (12,13) . DALK surgery offers the advantage of preserving the eye's integrity, potentially leading to lower complication rates during and after surgery.…”

Section: Discussionmentioning

confidence: 99%

Deep anterior lamellar keratoplasty and penetrating keratoplasty in macular corneal dystrophy: comparison of visual and topographic outcomes and complications

Balıkçı,

Burcu,

Akkaya

et al. 2024

ABO

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This study aims to assess and compare the postoperative visual and topographic outcomes, complications, and graft survival rates following deep anterior lamellar keratoplasty and penetrating keratoplasty in patients with macular corneal dystrophy. Methods: In this study we enrolled 59 patients (23 male; and 36 female) with macular corneal dystrophy comprising 81 eyes. Out of these, 64 eyes underwent penetrating keratoplasty, while 17 eyes underwent deep anterior lamellar keratoplasty. The two groups were analyzed and compared based on best-corrected visual acuity, corneal tomography parameters, pachymetry, complication rates, and graft survival rates. Results: After 12 months, 70.6% of the patients who underwent deep anterior lamellar keratoplasty (DALK) and 75% of those who had penetrating keratoplasty (PK) achieved a best-corrected visual acuity of 20/40 or better (p=0.712). Following surgery, DALK group showed lower front Kmean (p=0.037), and Q values (p<0.01) compared to the PK group. Postoperative interface opacity was observed in seven eyes (41.2%) in the DALK group. Other topography values and other complications (graft rejection, graft failure, cataract, glaucoma, microbial keratitis, optic atrophy) did not show significant differences between the two groups. The need for regrafting was 9.4% and 11.8% in the PK and DALK groups, respectively (p=0.769). Graft survival rates were 87.5% and 88.2% for PK and DALK; respectively (p=0.88 by Log-rank test). Conclusion: Both PK and DALK are equally effective in treating macular corneal dystrophy, showing similar visual, topographic, and survival outcomes. Although interface opacity occurs more frequently after DALK the visual results were comparable in both groups. Therefore, DALK emerges as a viable surgical choice for patients with macular corneal dystrophy without Descemet membrane involvement is absent.

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“…between the outcome of macular and granular corneal dystrophy which concluded comparable results. [ 28 ]…”

Section: Discussionmentioning

confidence: 99%

Complications in deep anterior lamellar keratoplasty – A retrospective cross sectional interventional analysis in a large series

Kodavoor¹,

Rathi

Dandapani³

2023

Oman Journal of Ophthalmology

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AIM: To analyse complications in patients managed with deep anterior lamellar keratoplasty (DALK) for diseases of anterior corneal stroma. MATERIALS AND METHODS: This was a retrospective analysis of all the patients who underwent DALK in a tertiary care center in South India from 2010 to 2021. A total of 484 eyes in 378 patients were included in the study. Patients who underwent DALK for advanced keratoconus, keratoconus with Bowman's membrane scar, healed hydrops, macular corneal opacity, macular corneal dystrophy, granular corneal dystrophy, spheroidal degeneration, pellucid marginal degeneration, post-LASIK ectasia, descemetocele, postcollagen cross-linking aborted melt and dense scar, and postradial keratotomy were included in the study. The patients were followed up for 17.6±9.4 months(1–10years). RESULTS: Complications noted in the surgery were intraoperatively Descemet's membrane perforation in 32 eyes (6.6%), postoperatively secondary glaucoma in 16 eyes (3.31%), cataract in 7 eyes (1.45%), suture-related complications in 5 eyes (1.03%), graft rejection in 3 eyes (0.61%), traumatic dehiscence in 2 eyes (0.41%), filamentary keratitis in 2 eyes (0.41%), interface infiltrate in 1 eye (0.21%), and recurrence of disease in 4 eyes (8.77%) out of 57 eyes with corneal dystrophy. CONCLUSION: DALK as an alternative to penetrating keratoplasty for anterior corneal stromal diseases has proven to be better time and again. It has become an automatic choice for diseases of anterior cornea requiring keratoplasty. Complications occurring at any stage of surgery can be identified and managed effectively resulting in optimal outcome. This article compiles complications post DALK.

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Deep anterior lamellar keratoplasty outcomes in macular and granular corneal dystrophy – A comparative cross-sectional study

Cited by 9 publications

References 21 publications

Complications in deep anterior lamellar keratoplasty – A retrospective interventional analysis in a large series

Complications in deep anterior lamellar keratoplasty – A retrospective interventional analysis in a large series

Deep anterior lamellar keratoplasty and penetrating keratoplasty in macular corneal dystrophy: comparison of visual and topographic outcomes and complications

Complications in deep anterior lamellar keratoplasty – A retrospective cross sectional interventional analysis in a large series

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