Posters

Long-term results in deep anterior lamellar keratoplasty performed with 'big-bubble' technique

Poster Details

First Author: L. Malheiro PORTUGAL

Co Author(s):    C. Vale   I. Casal   S. Monteiro   L. Oliveira   M. Gomes        

Abstract Details

Purpose:

To evaluate long term endothelial cell density (ECD) changes and visual and refractive outcomes after deep anterior lamellar keratoplasty (DALK) using the big-bubble technique and to compare it with data from the literature regarding penetrating keratoplasty (PK).

Setting:

Ophthalmology department of a tertiary referral centre in Oporto, Portugal, Centro Hospitalar do Porto.

Methods:

From May/2008 until March/2011, forty seven eyes of 47 patients with anterior lamella pathology not affecting the endothelium underwent DALK with the Anwar's big-bubble technique. Minimum follow-up is 5 years for all cases. ECD were obtained preoperatively and postoperatively. Other outcome measures were postoperative uncorrected and best spectacle-corrected visual acuity (UCVA and BSCVA) and topographic astigmatism.

Results:

Mean postoperative UCVA was 0,21 (range from CF to 0,5) and mean BSCVA postoperative was 0,62 (range from 0,2 to 1,0). At 12 months postoperatively, topographic astigmatism was 4,17 ± 2,7 D and remains stable after 5 years. Mean ECD loss was 7,2% ± 4,8% at 1 year and 10,2% ± 5,1% at 5 years follow-up.

Conclusions:

ECD loss is significantly lower in DALK (comparing to PK) and do not vary significantly on long term. There is no clinical difference in the outcomes of UCVA, BCVA and topographic astigmatism between DALK and PK. Although technically more demanding, DALK should be preferred over PK in eyes that preoperatively have normal endothelial cell counts.

Financial Disclosure:

NONE