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Outcomes of pneumatic dissection for DALK in pediatric patients

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Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Sunday 08/10/2017 | 10:30-12:30

Paper Time: 11:34

Venue: Meeting Center Room I

First Author: : L.Mattioli ITALY

Co Author(s): :    S. Madi   M. Ziosi   M. Busin              

Abstract Details


To report the outcomes of deep anterior lamellar keratoplasty (DALK) for the treatment of stromal corneal disease in otherwise healthy pediatric eyes.


Villa Igea private Hospital, Forli', Italy


All eyes of pediatric patients undergoing DALK under general anesthesia by the same surgeon (M.B.) between July 2013 and December (2016) were reviewed. DALK was performed in 12 eyes of 11 pediatric patients according to a modified technique combining pneumatic dissection with the use of a 9 mm donor button after clearing a central 6 mm optical zone. Slit-lamp examination, refraction and visual acuity were evaluated preoperatively as well as 1, 3, 6, 12 and 18 months postoperatively.


12 eyes of 11 patients with various indications (keratoconus n=7, post-infectious scars n=4, post-traumatic scar n=1) were included. The mean age at the time of surgery was 11.2 years. Pneumatic dissection succeeded in all but one case, which was completed by hand dissection. Postoperatively traumatic wound dehiscence occurred in one case 6 months after DALK and was managed by resuturing the wound with no loss of intraocular content. All corneas were clear at the last examination. With an avarage postoperative follow-up of 24 month best spectacle-corrected visual acuity improved to 20/40 or better in 9 of 10 non amblyopic eyes.


Pneumatic dissection can succeed in a percentage of pediatric eyes at least as high as that recorded in adult eyes. Visual results do not differ substantially from those obtained in this age group by means of penetrating keratoplasty, preventing the development of amblyopia in most cases.

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