Long-Term Results of Deep Anterior Lamellar Keratoplasty for the Treatment of Keratoconus

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

“…Postoperative BCVA scores were improved over preoperative values in all patients. These visual outcomes are comparable to results obtained in other studies using the big-bubble technique but involving the removal of the donor endothelium (15,16,23) . The incidence of graft rejection following DALK has been reported to range from 0% to 9.6% in various series (13,24,25) .…”

“…However, this lamellar technique involves a long learning curve, which can pose a challenge for many corneal surgeons (10) . Several studies have shown that visual acuity (VA) in patients with keratoconus after DALK with the big-bubble technique are similar to that of those who underwent PK (12)(13)(14)(15)(16)(17)(18) , yet there is little published data with respect to preparation of the donor corneal button. Some authors have suggested that removing the endothelium of the donor corneal graft results in an improved interface (19)(20)(21) .…”

Comparison of Visual Outcomes of Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty

“…DM perforation rate has been reported between 4.0%-39.2% and large DM tears needing conversion to PK between 2.3%-27.3% in the literature. 13,14 Our rates are consistent with these reports.…”

“…Although stromal rejection episodes have been reported in 1.7% to 11.3% within 4 yrs., no rejection episode was observed in our DALK cases. 14,18 The median predicted survival was reported as 49.0 yrs. in DALK and 17.3 yrs.…”

Etiology and Clinical Presentation of Astigmatism

“…Astigmatism following deep anterior lamellar keratoplasty (DALK) was reported in two groups (Kubaloglu et al 2011): descemetic DALK (dDALK), or pre-descemetic DALK (pdDALK). The results were similar: 3.73±1.42 on the pdDALK group (mean±SD), and 3.52±1.53 in the dDALK group.…”