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Outcomes of deep anterior lamellar keratoplasty for extensive spheroidal degeneration
Poster Details
First Author: A.Nagpal INDIA
Co Author(s): B. Kaur S. Mahuvakar
Abstract Details
Purpose:
To evaluate visual outcomes, complications and graft survival of patients
undergoing deep anterior lamellar keratoplasty (DALK) to treat extensive Spheroidal
degeneration.
Setting:
Centre for Corneal Disease and Surgery,
Retina Foundation, Ahmedabad, Gujarat, INDIA
Methods:
In this retrospective, noncomparative
study, 12 eyes with Spheroidal degeneration
that underwent DALK between June 2008 and August 2012 were included. DALK was
performed using a modification of 'Groove and Peel technique ' with preDescemet's
membrane dissection and the Data collected for analysis included preoperative
characteristics, intraoperative complications and postoperative acuity, complications and
subsequent operations.
Results:
Mean followup
was 44 ± 18 months. Preoperatively BSCVA was 6/60 or worse in all
eyes. . 35% of patients with more than 2 years followup
had a best corrected distance visual
acuity of 6/18 or better and 60% were 6/24 or better. Intraoperative microperforation at the site
deep involvement occurred in four eyes but none required conversion to penetrating
keratoplasty. 6 eyes had delayed epithelisation and required temporary tarsoraphhy. Mean
postoperative keratometry was 44.3 ± 2.4 and central pachymetry 582.6 ± 55.0 μm. 3 eyes
experienced a episode of stromal graft rejection. 8 eyes underwent subsequent cataract
surgery.
Conclusions:
DALK in eyes with Spheroidal degeneration is a safe and effective option that
preserves host endothelium with favourable results. DALK in these eyes is associated with
delayed epithelisation and patients should be aware of this when giving informed consent for
DALK for extensive Spheroidal degeneration. FINANCIAL INTEREST: NONE