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First Author: N.Fernandez Meijide ARGENTINA
Co Author(s): J. Bekerman
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To evaluate the functional results after Descemet"s membrane perforation during deep anterior lamelar keratoplasty. (DALK)
Private Hospital, Buenos Aires, Argentina
A retrospective study evaluated a series of 5 eyes that had a perforation with no conversion to penetrating keratoplasty (PK) during DALK using the big-bubble technique.
The mean age of the patients was 38 year old ±5,75 (SD). The mean follow up time was 8,8 months ḟ5,8. Preoperative diagnosis was keratoconus (2 patients), keratoconus and history of hydrops (1 patient), keratoconus and history of acanthamoeba keratitis (1 patient) and herpetic keratitis (1 patient). Intraoperative perforation occurred during manual deep dissection in 3 eyes (60%) and while placing sutures in 2 eyes (40%). In all 5 eyes, DALK could be completed and there was no need to do a PK. The most common postoperative complication was seudochamber between the donor stroma and the recipient Descemet"s membrane. Air injection into the anterior chamber was necessary in 4 cases. The average postoperative visual acuity was 4.0 ±1,78.
Small intraoperative perforations during DALK had a good prognosis with no need for conversion to PK, however in most cases an injection of air into the anterior chamber was required.