ESCRS - FPM02.02 - Outcomes Of Conventional 8.0-Mm Versus Large 9.0-Mm Diameter Deep Anterior Lamellar Keratoplasty For Keratoconus

Outcomes Of Conventional 8.0-Mm Versus Large 9.0-Mm Diameter Deep Anterior Lamellar Keratoplasty For Keratoconus

Published 2022 - 40th Congress of the ESCRS

Reference: FPM02.02 | Type: Free paper | DOI: 10.82333/xbgf-ft94

Authors: Luca Furiosi* 1 , Andrea Lucisano 2 , Angeli Christy Yu 3 , Giuseppe Giannaccare 2 , Massimo Busin 3 , Vincenzo Scorcia 2

1Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy, 2Department of Ophthalmology,University of Magna Graecia ,Catanzaro,Italy, 3Department of Translational Medicine,University of Ferrara,Ferrara,Italy

Purpose

To compare the clinical outcomes of large diameter and conventional big-bubble

deep anterior lamellar keratoplasty.

Setting

Tertiary Eye Care Referral Center (Department of Ophthalmology, University of Magna Graecia, Catanzaro, Italy)

Methods

In this single-center study, medical records of 124 cases of large 9.0-mm

diameter DALK from March 2017 to December 2019 and 132 conventional 8.0-mm

DALK from January 2012 to February 2017 performed by a single-surgeon for the

indication of keratoconus were reviewed. Main outcome measures were best

spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA) and

postoperative complication rates.

Results

Postoperative logMAR BSCVA did not significantly differ between 9.0-mm
and 8.0-mm DALK at any time points. The 9.0-mm DALK group had a significantly
higher percentage of eyes achieving 20/20 or better (9.0-mm DALK: 44%, 8.0-mm
DALK: 26%, p=0.01) and 20/25 or better (9.0-mm DALK: 74%, 8.0-mm DALK: 59%,
p=0.03) Snellen BSCVA. RA was significantly lower in the 9.0-mm DALK
group compared with the 8.0-mm DALK group during all time points (p<0.001). The
percentage of eyes with RA less than or equal to 4.5 D was significantly lower in
the 9.0-mm DALK patients (90%) compared with in 8.0-mm DALK group
(72%)(p=0.02). Postoperative complication rates were similar between groups

Conclusions

Compared to conventional 8.0-mm DALK, large 9.0-mm DALK

can provide satisfactory visual outcomes and significantly lower degrees of

astigmatism without an increased risk of immune rejection and graft failure.