Posters

Visual, topographic and tomographic results in patients undergoing deep anterior lamellar keratoplasty (DALK)

Poster Details

First Author: M.Benedetti MEXICO

Co Author(s): B. Elinzondo   A. García Albisua   A. Tapia Vázquez   G. de Wit Carter           

Abstract Details

Purpose:

To determine the visual, topographic and tomographic results in patients who underwent deep anterior lamellar keratoplasty, comparing these values basal, first month and one year after surgery.

Setting:

An increase of visual capacity and a decrease of keratomety will be found one year after deep anterior lamellar keratoplasty.

Methods:

Retrospective, longitudinal, observational and descriptive study. Consecutive recruitment of patients undergoing DALK in the Cornea and Refractive Surgery service in “Asociación para Evitar la Ceguera en México”, was performed during the last 5 years. The data was obtained from the clinical record: age, diagnosis, laterality, uncorrected and better corrected visual acuity, spherical equivalent, K1,K2 and avarage keratometry using Scheimpflug Camera, topography and OCT images. Statistical Analysis was performed with Graphrad Prism software. Quantitative variables are described by median and interquiartile range with Shapiro-Wilk normality test.  Wilcoxon test was used to compare basal versus 1-year visual acuity and keratometry.

Results:

23 eyes of patients undergoing DALK were included in an age range between 11-47 years with an avarage of 25 years. There was no gender predominance (12 men and 11 women) or laterality. The most frequent diagnosis was keratoconus (19 eyes) followed by two cases of radial keratotomy, penetrating trauma and alkali burn. The average presurgical visual capacity of 1,0 LogMar increased to 0,3 1 year after the procedure, with statistically significant difference (p=0,0001). The average presurgical keratometry of 64,95D decreased to 46,3D 1 after one year. The most frequent complication was double chamber, appearing in 3 of 23 cases.

Conclusions:

The ideal surgical treatment of corneal pathology should replace only the altered layers so deep anterior lamellar keratoplasty is a suitable alternative for corneal pathology limited to the anterior layers. In this study, the post-surgical improvement of visual acuity was significant, as well as the keratometric changes. In patients with anterior corneal pathology candidates for penetrating keratoplasty it is recommended to try DALK, although the technique difficulty and the surgical time are greater, the visual and keratometric results are comparable to PK in addition to other safety advantages already mentioned.

Financial Disclosure:

None