Outcomes of Deep Anterior Lamellar Keratoplasty for Spheroidal Degeneration
Narrative Responses:
Purpose
To evaluate visual outcomes, complications and graft survival of patients undergoing deep anterior lamellar keratoplasty (DALK) to treat extensive Spheroidal degeneration.
Methods
In this retrospective, non-comparative 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 pre-Descemet's membrane dissection and the Data collected for analysis included preoperative characteristics, intraoperative complications and postoperative acuity, complications and subsequent operations.
Results
Mean follow-up was 44 ± 18 months. Preoperatively BSCVA was 6/60 or worse in all eyes. . 35% of patients with more than 2 years follow-up 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.
Conclusion
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.