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A comparative study: deep anterior lamellar keratoplasty for corneal dystrophies using two different donor stromal tissues

Poster Details

First Author: Y.Ko├žluk TURKEY

Co Author(s):    E. Alyamac Sukgen                    

Abstract Details


When descemet membrane endothelial keratoplasty (DMEK) is performed just before deep anterior lamellar keratoplasty (DALK), some discoloration on the donor tissue may be observed due to the added exposure to trypan blue solution. This study aimed to present a comparison of early post-operative results in DALK surgery performed using the two different corneal graft sources.


This retrospective clinical study was conducted in the ophthalmology clinic of a tertiary care center between January 2015 and June 2016 in Adana Numune Training and Research Hospital, Adana, Turkey.


At the time of surgery, donor stromal tissue for DALK was sourced using the two different preparatory techniques. For 14 cases (Group 1), the donor grafts were prepared quickly by removing the descemet's membrane (DM) without much care after the exposure of the bare DM in the recipient cornea. For 12 cases (Group 2), the grafts for DALK surgery had already been prepared during a previous DMEK.


The groups differed statistically regarding the blue staining of the grafts at the time of surgery and on the first day. The first day after surgery, 14 (100%) grafts were clear in Group 1, while eight (66.7%) grafts were clear and four (33.3%) were edematous in Group 2 (p = 0.019). Bubbling was performed in three (25.0% of Group 2) of the four cases on the first day post-DALK, while none of the patients in Group 1 underwent this procedure (p = 0.47). Visual acuity was higher in Group 1 in the early post-operative period (p = 0.012).


During the early post-operative period, complications (as graft edema, detachment, rebubbling) were observed more frequently in the DALK operations performed with stromal tissue having blue stain remaining from the DMEK performed on the same day and in the same session.

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