Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

Dooren, Bart T. H. van; Mulder, Paul; Nieuwendaal, Carla P.; Beekhuis, W. H.; Melles, Gerrit R.J.

doi:10.1016/j.ajo.2003.09.053

Cited by 101 publications

(57 citation statements)

References 13 publications

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“…DLK has been shown to only minimally decrease endothelial cell counts with cell counts being maintained for a longer period [1, 14, 16, 17]. Shimazaki et al[ 15] also demonstrated that in patients undergoing PKP as opposed to DLK, there was a progressive decrease in endothelial cell density over 24 months.…”

Section: Discussionmentioning

confidence: 89%

Deep Lamellar Keratoplasty in the Treatment of Keratoconus

Pakrou¹,

Fung²,

Selva³

et al. 2006

Ophthalmologica

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Purpose: To present our experience with a series of patients treated with deep lamellar keratoplasty (DLK) for keratoconus (KC). Design: A single surgeon, prospective, consecutive series.Method: The study included all patients with KC who underwent DLK between March 1999 and November 2003 at the Royal Adelaide Hospital. The parameters evaluated included patients’ demographics, pre- and post-operative best corrected visual acuities, post-operative keratometry, and intra- and post-operative complications. Results: There were 22 patients (23 eyes); 10 females and 12 males, with a mean age of 35 ± 13 years (median, 33.5; range, 17–73). The median follow-up period was 13 months (range 7–38). In 89% (16/18) of eyes which underwent DLK, and in which a visual acuity could be obtained, a best corrected visual acuity of at least 6/12 was recorded. There were two episodes of Descemet’s membrane perforation (8.7%), in which the procedure was converted to penetrating keratoplasty without complications. One patient developed a double anterior chamber, which resolved spontaneously without consequences. Conclusion: The visual outcomes and complication rates seen in our series are comparable to the recent published literature. Hence DLK can be considered as a suitable alternative to penetrating keratoplasty for the surgical treatment of KC.

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Section: Discussionmentioning

confidence: 89%

Deep Lamellar Keratoplasty in the Treatment of Keratoconus

Pakrou¹,

Fung²,

Selva³

et al. 2006

Ophthalmologica

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“…Bizim çalısmamızda ki DM perforasyon oranı %12.8 iken benzer çalışmalarda bu oran %9 ile %15 arasında değişmektedir. [29] Çalışmamızda birinci yılın sonunda endotel hücre kaybı %6.6 ve ikinci yılın sonunda %9.5 olarak rapor edilmiştir. Benzer çalışmalarda bu oran altı ayın sonunda %11, birinci yılın sonunda %17 ve ikinci yılın sonunda %13 olarak bildirilmiştir.…”

Section: Discussionunclassified

“…Benzer çalışmalarda bu oran altı ayın sonunda %11, birinci yılın sonunda %17 ve ikinci yılın sonunda %13 olarak bildirilmiştir. [29,30] DALK cerrahisi penetran keratoplasti ile karşılaştırıldığında daha az endotel hücre kaybına neden olur ve teorik olarak endotel kaynaklı rejeksiyon görülmemektedir. DALK sonrası endotelyal rejeksiyon görülmese de nadirde olsa stromal rejeksiyon krizinin gelişebileceği gösterilmiştir.…”

Section: Discussionunclassified

Techniques in the treatment of keratoconus patients with big-bubble deep anterior lamellar keratoplasty long-term results of operation

Genç¹,

Sarı²

2014

J Kartal TR

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Erken ameliyat sonrası dönemde sekiz gözde (%3.9) DM dekolmanı izlendi. Ön kamaraya hava verilmesi ile dekolman yedi gözde düzel-di. DM dekolmanı izlenen gözlerin birinde ise çift ön kamara gelişti ve bu göze cerrahi sonrası altıncı ayda penetran keratoplastiuygulandı. Gözlerin yedisinde (%3.4) pupiller bloklu akut glokom krizi gelişti. Takiplerde beş gözde (%2.5) stromal greft rejeksiyonu gelişti. Medikal tedavi ile rejeksiyon tüm gözlerde düzeldi.Sonuç: Keratokonuslu gözlerde big-bubble tekniği ile uygulanan DALK cerrahisi başarılı görsel ve refraktif sonuçlar sağlamaktadır. Bu teknik penetran keratoplastiye iyi bir alternatif olarak düşünülebilir.Anahtar sözcükler: Big-bubble tekniği; derin anterior lameller keratoplasti; keratokonus; penetran keratoplasti. Summary Background: To evaluate the visual and refractive outcomes and potential complications of Deep Anterior Lamellar Keratoplasty (DALK) using the big-bubble technique in eyes with keratoconus. Methods: In this study, 203 keratoconic eyes of 184 patients who underwent DALK surgery using the big-bubble technique were analyzed. Preoperatively and at control visits, a complete ophthalmic examination was performed including uncorrected visual acuity (UCVA), best-

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“…89 Kubaloglu et al reported changes in endothelial cell density after DALK (Descemetic, big-bubble technique) in 166 keratoconus cases. 90 The average losses were 8.1 ± 4.6% at 1 year and 10.5 ± 5.7% at 2 years.…”

Section: B Endothelial Cell Lossmentioning

confidence: 99%

“…69 It is expected that cell loss in DALK would be similar to physiological rates in a normal adult. 89,95,96 …”

Section: B Endothelial Cell Lossmentioning

confidence: 99%

Deep Anterior Lamellar Keratoplasty for Ectatic Disease

Ramos¹,

Schor²,

Luz³

et al. 2013

International Journal of Keratoconus and Ectatic Corneal Diseases

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Recently, deep anterior lamellar keratoplasty (DALK) has received attention for patients with ectatic diseases not affecting the endothelium. However, it was not always so. For years, DALK was overlooked due to the difficulty in achieving good visual results, which were considered weak in comparison with the results of penetrating keratoplasty (PK). DALK was proposed to retain a patient's healthy endothelium; thereby avoiding some possible complications of PK. Preservation of the endothelium contributes to prolonged survival of the button and thus overcomes a major cause of failure after PK. DALK is now accepted as a viable alternative to PK. With advances in surgical techniques, instruments, and imaging technologies, visual results obtained with lamellar keratoplasty are equivalent to visual outcomes with PK, in addition to providing a transplant cost benefit owing to a better transplantation survival rate.

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Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

Cited by 101 publications

References 13 publications

Deep Lamellar Keratoplasty in the Treatment of Keratoconus

Deep Lamellar Keratoplasty in the Treatment of Keratoconus

Techniques in the treatment of keratoconus patients with big-bubble deep anterior lamellar keratoplasty long-term results of operation

Deep Anterior Lamellar Keratoplasty for Ectatic Disease

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