Posters

Deep anterior lamellar keratoplasty (DALK): 10 years' experience in Centro Hospitalar Universitário do Porto

Poster Details

First Author: P.Baptista PORTUGAL

Co Author(s):    A. Marta   R. Vieira   L. Malheiro   M. Neves   M. Gomes   L. Oliveira     

Abstract Details

Purpose:

The purpose of this work is to present the clinical experience with Deep Anterior Lamelar Keratoplasty (DALK) in Centro Hospitalar Universitário do Porto.

Setting:

Corneal diseases with preserved endothelial function has an indication for corneal transplantation with DALK. This technique has advantages compared with penetrating keratoplasty, such as lesser rejection risk, epithelial loss, post-operative need of corticoid, and glaucoma incidence, and a higher corneal resistance to trauma. When possible, this technique should be considered.

Methods:

Retrospective study of patients submitted to Corneal transplantation with DALK, between August 2008 and July 2018. The indication for surgery, Best Corrected Visual Acuity (BCVA) evaluated with logMAR scale, ametropy correction techniques after transplantation and endothelial loss were analyzed.

Results:

135 DALKs were performed, 60 in the first 5 years and 75 in the second. The main indication for DALK was keratoconus (92,9%), DALK Big Bubble was the most performed. Patients with > 7 years follow-up (n=28), improved BCVA from 1,30±1,48 in the first pre-surgical appointment to 0,14±0,57 in the final follow-up appointment. In these patients, surgical and/or LASER high ametropy correction was carried out with phakic intra ocular lens (IOL) (35,7%),  LASER Excimer (25,0%), arcuate keratotomy (3,6%), phakoemulsification with pseudophakic IOL implementation (7,1%) or combination of treatments (10,7%). A mean yearly endothelial loss of 0,74% cells/mm2 was observed.

Conclusions:

DALK corneal transplantation is associated with a low complication risk and a good functional long-term result. High ametropy can be corrected with several surgical and/or LASER techniques. Observed endothelial loss is similar to physiological age-associated endothelial loss.

Financial Disclosure:

None