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Deep anterior lamellar keratoplasty: a retrospective review of an 8-years experience

Poster Details

First Author: A.Gonçalves PORTUGAL

Co Author(s):    D. Cordeiro Sousa   R. Marques   A. Quintas   P. Guerra   W. Rodrigues        

Abstract Details


Deep anterior lamellar keratoplasty (DALK) allows the preservation of the host endothelium and Descemet's membrane. Therefore, it can be considered as first-line therapy in patients with anterior corneal opacification or corneal structural defects with healthy and functional endothelium. We aimed to evaluate DALK surgery and the 8-year results of a tertiary university hospital in Lisbon.


Ophthalmology Dept., Hospital de Santa Maria, Lisbon, PT.


Retrospective clinical chart review, including all DALK performed at CHLN since 2010 until February 2017. We analyzed the demographic characteristics of the patients, surgical indications, the chosen technique, intra and postoperative complications and visual results.


Thirty DALK were performed, mostly with �â�€�œBig Bubble�â�€� technique (DALK-BB) (90% versus 10% manual dissection). Mean patients' age was 34.0 � 12.2 years. Keratoconus was the major indication for surgery (83,3%), followed by corneal leucoma (10%), pellucid marginal degeneration (3,3%) and ectasia after refractive surgery (3,3%). Conversion rate to penetrating keratoplasty was approximately 20%. There were 4 cases (13,3%) of epithelial/stromal rejection after a successful DALK. Removal of sutures occurred on average 7 months after surgery, depending on induced astigmatism. Mean pre- and postoperative best-corrected visual acuity (Snellen) was 0,16 � 0,09 and 0,7 � 0,24, respectively.


DALK-BB is a safe and, effective technique, associated with a low rejection rate. Thus, it may be considered as first-line therapy for anterior corneal diseases along with a healthy endothelium.

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