Posters

Outcomes of descemetopexy after deep anterior lamellar keratoplasty

Poster Details

First Author: A.Kate INDIA

Co Author(s):    P. Vaddavalli   A. Koul                 

Abstract Details

Purpose:

Deep Anterior Lamellar keratoplasty has now progressed to being the preferred surgical procedure for anterior stromal corneal pathologies. However, the surgical procedure commonly involves microperforations which can result in the formation of double anterior chamber post operatively. Such cases may be taken up for descemetopexy using air bubble or perfluoropropane gas or are sometimes managed conservatively to look for resolution. We report visual outcomes and success rate of this descemetopexy procedure done for 25 patients.

Setting:

Tertiary Eye Care Centre in India

Methods:

A retrospective review of DALK performed over a period of 2 years from 2016 to August 2018 was done. Demographic data, indication for surgery and operative notes were reviewed. The visual acuity and the anterior segment findings were evaluated and extent in terms of quadrants involved were tabulated. Descemetopexy was considered a failure in cases where the Descemet membrane was still detached and the patient required a full thickness penetrating keratoplasty subsequently. Results in success and failure groups were compared to find any significant role of indication of surgery or type of dissection done during the surgery.

Results:

DALK was done using big bubble technique in 15 patients and manual dissection in 10 patients. Intraoperatively perforation was noted in 9 eyes. Post-operatively, the detachment involved 1 quadrant in 4 eyes,  2 quadrants in 6 eyes, 3 quadrants in 8 eyes (32%) and 4 quadrants in the remaining 7 eyes. The average visual acuity post DALK on first operative day was -1.224 LogMAR (±0.40). Descemetopexy was done in 2 cases using perfluoropropane (C3F8) whereas air was used in 23 cases.Post-descemtopexy, the visual acuity postoperatively was -0.54± 0.42, with anatomical success being achieved in 17 eyes.

Conclusions:

Descemetopexy following DALK offers favourable outcomes in terms of rapid resolution and goof final visual recovery. The indication for surgery, type of dissection or extent of detachment does not play a role in the final outcome of the procedure. However, this could be attributed to the small numbers in the subgroup analysis, indicating the need for larger studies on the same.

Financial Disclosure:

None