Posters

Inverse keratoconus, a late finding in keratoconus patients after DALK

Poster Details

First Author: J. Reddy INDIA

Co Author(s):                        

Abstract Details

Purpose:

To report and analyse the incidence of inverse keratoconus in patients who underwent DALK for keratoconus, of central island of flattening of the graft associated with thinning and to further analyse this finding

Setting:

Retrospective case series study at Sankara Eye Centre, Coimbatore India

Methods:

Retrospective review of patients who underwent DALK for keratoconus at Sankara Eye Centre, Coimbatore, India from 2007 to 20016 was done. Patients who completed 4 years of follow up were included. Slit lamp findings, corneal topography and central corneal pachymetry were analysed.122 eyes of 71 patients were analysed. Uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity (BCVA) were analysed in each visit.

Results:

31 eyes of 31 patients showed topographic evidence of central island of flattening which correlated with slit lamp finding of sub epithelial haze of varying density. The pachymetry reading of the central cornea varied from 400 to 479µ and correlated with topographic findings. The average onset of central sub epithelial haze was at 12 months post DALK. The central haze progressed over time and was associated with thinning of the cornea. The onset and progression of central flattening was associated with corresponding decrease in UCVA and BCVA. No epithelial defect was noted.

Conclusions:

25% of keratoconus patients who underwent DALK developed a central island of flattening with associated decrease in the visual acuity in 5 years average post operative period. The central haze, flattening and thinning may be a chronic stromal rejection or progressive thinning of cornea associated with keratoconus or due to reduced corneal sensations.

Financial Disclosure:

NONE