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First Author: E.Sogutlu Sar? TURKEY
Co Author(s): A. Kubalo?lu M. Ünal Y. Özertürk
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To compare outcomes of big-bubble deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) for macular corneal dystrophy (MCD).
Kartal training and research hospital
The study is a prospective, randomized, interventional case series. Eighty-two eyes of 54 patients requiring keratoplasty for the treatment of MCD without endothelial involvement were included. Operative complications, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity function (CSF), higher order aberrations (HOA) and endothelial cell density (ECD) were evaluated.
The DALK and PK group consisted of 35 and 41 eyes respectively. Postoperatively BCVA was 20/40 or better 68.5% and 70.7% of the eyes in DALK and PK group respectively (p>.05). No statistically significant differences between groups were found in CSF with and without glare for any spatial frequency (p>.05). Significantly higher levels of HOA were found in the DALK group (p <.01). In both groups, a progressive and statistically significant reduction in ECD was found ( p<.01). At the last follw-up the mean endothelial cell loss was 18.1% and 26.9% in DALK and PK groups respectively ( p=.03). Graft rejection episodes were seen in 5 eyes (12.1%) in PK group and regrafting was necessary in 3 eyes (7.3%). Recurrence of the disease was documented in 5.7% and 4.8% of the eyes from DALK and PK group respectively.
DALK with the big-bubble technique provided comparable visual and optical results to PK and resulted in less endothelial damage as well as eliminated endothelial rejection in MCD patients. DALK surgery is a viable option for MCD without endothelial involvement.