Use of deep anterior lamellar keratoplasty (DALK) for keratoconus: indications, techniques and outcomes

Feizi, Sepehr; Javadi, Mohammad Ali; Fekri, Yousef

doi:10.1080/17469899.2016.1222904

Cited by 13 publications

(11 citation statements)

References 84 publications

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“…This method allows the surgeon to use larger (9 mm) grafts which support better bonding between the donor and host corneas without placing the endothelium at risk. 148 Parker et al. reported stromal rejection rates of 3–14.3% after DALK, and 3–31% may occur during the first three days after surgery.…”

Section: Methodsmentioning

confidence: 99%

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Updates on Managements for Keratoconus

Mohammadpour

Heidari

Hashemi

2018

Journal of Current Ophthalmology

101

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PurposeKeratoconus is a progressive disease of the cornea which can lead to blindness as irregular astigmatism increases. Currently, a variety of methods are available for the treatment of keratoconus, and in certain cases, it may be difficult to choose the most appropriate option. This article reviews available treatment modalities for keratoconus to provide the practitioner with practical and useful information for selecting the most suitable option for each individual patient.MethodsTo review treatment methods for different stages of keratoconus, PubMed (United States National Library of Medicine) and Scopus (Elsevier BV) databases were searched using the keywords “keratoconus”, “contact lens”, “cross-linking”, “Intacs”, “keratoplasty”, “gene therapy”, and “irregular astigmatism”, and related articles were reviewed based on disease assessment parameters and treatment methods.ResultsVarious methods are available for the treatment of keratoconus: eyeglasses and contact lenses in the early stages, cross-linking for stabilizing disease progression, intrastromal corneal ring segments (ICRS) for reducing refractive errors or flattening the cornea, and penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK), conductive keratoplasty, gene therapy and more recently, bowman layer transplantation (BL transplantation) in advanced stages of the disease. To achieve optimum results, it is essential to choose the best option for each individual patient.ConclusionsA commonality of the reviewed papers was the advancement of novel diagnostic and treatment methods in ophthalmology, which can delay the need for corneal grafting. A better understanding of keratoconus treatment options can help enhance visual rehabilitation and prevent blindness in keratoconus patients.

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Section: Methodsmentioning

confidence: 99%

“… 151 The different techniques of DALK include layer-by-layer manual dissection, Archila, Melles, Anwar's big-bubble, viscoelastic dissection, hydrodelamination, and femtosecond laser-assisted DALK. 148 …”

Section: Methodsmentioning

confidence: 99%

Updates on Managements for Keratoconus

Mohammadpour

Heidari

Hashemi

2018

Journal of Current Ophthalmology

101

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“…Such condition is developed during [10] About this corneal vascularization in 22.22% (n=4) of the cases, it is a factor that should be considered to be one of the complications of DALK due to surface and suture changes. Thus, a history of anterior vascular keratoplasty could represent a triggering factor for corneal opacification [11].…”

Section: Discussionmentioning

confidence: 99%

“…The good results in keratoconus patients have led surgeons to use this technique in other conditions. Therefore, the information to perform DALK have expanded to other corneal ectasia, stromal dystrophies, scarring, stromal opacities, corneal ulcers and even cases of perforations [11].…”

Section: Discussionmentioning

confidence: 99%

Lamellar keratoplasty in a referral center in northeastern Brazil

Dantas

Silva

et al. 2016

Int Arch Med

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Objective: To clinically characterize some cases of lamellar keratoplasty performed in a referral center of Rio Grande do Norte state.Methods: This is a cross-sectional, retrospective study, which is the review of the medical records of 18 patients who underwent keratoplasty of lamellar type in a referral service in Natal/RN.Results: it was found that of 18 patients who underwent keratoplasty, 55.56% were male, being all patients with deep anterior lamellar. Regarding the age group, 66.67% were thirty years old or less. The corneal vascularization of tissue was a factor receptor absent in 77.78% of cases. The main indication for lamellar keratoplasty were keratoconus (66.66%). Of the cases in which transplantation was done with urgency, ocular diagnoses were not infectious ulcerative keratitis (50%), corneal degeneration (25%) and leukoma (25%). Conclusion:it is cocluded that the main indicator condition for lamellar keratoplasty was keratoconus. Patients who underwent the procedure were 30 years old or less, with minimum level of corneal vascularization and absence of glaucoma. Furthermore, the surgical technique predominantly used for lamellar transplantation was the deep lamellar keratoplasty due to its advantages over penetrating keratoplasty.

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“…При КК метод используют для достижения глубины стромы, близкой к ДМ. Он позво ляет хирургу использовать более крупные (9 мм) трансплантаты, которые обеспечивают лучшую связь между роговицей донора и реципиента, не подвергая эндотелий риску [15,16]. J. Parker и соавторы сообщили о частоте отторжения стромы, равной 3-14,3% после ГПКП, а вероятность отторжения трансплантата в течение первых трех дней после операции равна 3-31% [11].…”

Section: обзоры литературы Literature Reviewsunclassified

Methods of surgical treatment of keratectasia and analysis of postsurgical quality of vision

Sheludchenko¹,

Voronin²,

Djalili³

2020

Vestn. oftal'mol.

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РЕЗЮМЕ Кератэктазии-невоспалительные дистрофические заболевания роговицы, характеризующиеся прогрессирующим билатеральным ее истончением, которые приводят к ухудшению количественных и качественных характеристик зрения, что снижает в целом качество жизни пациента. Изменения могут быть асимметричными и деструктивными. Предложен целый ряд операций для уменьшения негативных влияний кератэктазии. К ним относятся сквозная кератопластика и ее модификации, имплантация корнеальных сегментов, кросслинкинг роговицы как изолированно, так и в сочетании с другими методами, интрастромальная кератопластика. Эти методы в разной степени могут улучшать остроту зрения и способствовать замедлению прогрессирования кератэктазии. В данной статье наряду с исследованием различных хирургических методов лечения кератэктазии проанализирована возможная оценка качества зрения до и после лечения.

show abstract

Use of deep anterior lamellar keratoplasty (DALK) for keratoconus: indications, techniques and outcomes

Cited by 13 publications

References 84 publications

Updates on Managements for Keratoconus

Updates on Managements for Keratoconus

Lamellar keratoplasty in a referral center in northeastern Brazil

Methods of surgical treatment of keratectasia and analysis of postsurgical quality of vision

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