Posters

Deep anterior lamellar keratoplasty after Descemet's stripping automated endothelial keratoplasty

Poster Details

First Author: S. Gutfreund ITALY

Co Author(s):    P. Leon   S. Graffi   R. Spena   V. Scorcia   M. Busin        

Abstract Details

Purpose:

To report the indications and long term outcomes of Deep Anterior Lamellar Keratoplasty (DALK) after Descemet Stripping Automated Endothelial Keratoplasty (DASEK) in cases of visual restricting stromal opacities

Setting:

Ophthalmology Department, Vila Igea Private Hospital, Forli, Italy

Methods:

The medical records of all patients who had undergone DALK after DSAEK at Villa Serena-Villa Igea Private Hospital were reviewed. Indications for the subsequent DALK surgery included both residual post-DSAEK stromal opacity and stromal opacity occurring in a formerly clear stroma. Best corrected visual acuity (BCVA),manifest refraction and endothelial cell density were assessed preoperatively and postoperatively.

Results:

Thirteen eyes from 13 patients who had undergone DALK after DSAEK were identified. Mean follow-up time after DALK was 23 months (Range 6 to 46). Indications for DASEK were: failed PK (N=8), failed DSAEK (N=3) and Pseudophakic bullous keratopathy (N=2).Indications for DALK post-DSAEK included residual stromal opacity (n=9), post-DSAEK herpetic keratitis (n=2) and post-DSAEK interface infection (n=2).No intraoperative complication occurred in any case. BCVA improved in 12 out of 13 eyes. Mean post-operative BCVA in all eyes without ocular comorbidities was 20/30.After complete suture removal, mean refractive cylinder was 3.2±1.4D, with all but one eye ending up with ≤ 4.00D.

Conclusions:

Performing a DALK on DSAEK is a safe procedure with favorable visual results that allows 'closed system' surgery while avoiding the replacement of an healthy endothelial graft..

Financial Disclosure:

One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented