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Clinical outcomes of deep anterior lamellar keratoplasty using big-bubble technique in keratoconus with stromal scarring

Poster Details

First Author: M.Ozmen TURKEY

Co Author(s):    K. Ceylanoglu   T. Atalay   E. Yuksel   B. Aydin   K. Bilgihan   F. Akata     

Abstract Details


To report clinical outcomes of deep anterior keratoplasty (DALK) using big bubble technique in keratoconus patients with stromal scarring.


Gazi University Medical School, Department of Ophthalmology


Keratoconus patients with stromal scars were included in this study. Deep anterior lamellar keratoplasty (DALK) was performed by big-bubble technique. Intraoperative and postoperative complications, best corrected visual acuity (BCVA), keratometric readings, endothelial cell count, and anterior segment optical coherence tomography (OCT) findings were recorded.


Twenty two eyes of 22 patients were included. Mean age was 30 years. Mean follow-up period was 24(± 4) months. Mean preoperative and postoperative final visit BCVA was 1.3(±0.4) and 0.42(±0.2) LogMAR respectively. Mean preoperative and postoperative final visit keratometry was 61.2(±15) and 41.6±(9.8) diopters respectively. Successful big bubble formation was achieved in 16 of 22 patients. In 4 eyes, the procedure was converted to penetrating keratoplasty because of Descemet’s membrane macroperforations. There was no difference in the outcome of surgeries regarding the depth of the stromal scar measured by anterior segment OCT.


In keratoconus patients with stromal scars, DALK surgery using the big-bubble technique is effective. Depth of stromal scar does not seem to alter the outcome of the surgery. DALK is an alternative to penetrating keratoplasty in keratoconus patients with stromal scarring.

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