Clinical Outcomes Before and After Removal of Sutures for DALK With Big-Bubble Technique
Narrative Responses:
Purpose
To evaluate clinical outcome of deep anterior lamellar keratoplasty (DALK) with the big bubble technique in keratoconus.
Methods
Big bubble DALK was performed on 105 consecutive eyes with moderate and advanced keratoconus; sutures were removed after 1 year; refractive and visual outcomes were measured at 1, 3, 6, 12 and 18 months. Corneal topographic indices and high order aberrations were measured before and after operation and after removal of sutures.
Results
Big bubble was attained in 91%; Descemet’s membrane exposed in 97.2% eyes. Mean spherical equivalent of refraction was -2.85 ± 3.55 D and -3.06 ± 3.77 D (p > 0.05); mean cylinder was 3.42 ± 1.93 D and 3.16 ± 2.68 D (p > 0.05) at 12 and 18 months respectively. Mean corrected visual acuity was 0.14 logMAR at 18 months. Simulated keratometry readings, surface asymmetry index (SAI) and surface regularity index (SRI) significantly decreased at 12 months after surgery (p<0.05). Root mean square (RMS) of total high order aberrations decreased after operation (p<0.05).
Conclusion
DALK with the big bubble technique is effective, reproducible and safe for Descemet’s membrane exposure. There is no significant change in astigmatism, topographic indices or high order aberrations after removal of sutures.