Corneal Topographic Changes In Deep Anterior Lamellar Keratoplasty For Keratoconus
Published 2023 - 41st Congress of the ESCRS
Reference: PO0227 | Type: Free paper | DOI: 10.82333/0v8g-0a41
Authors: Murugesan Vanathi 1 , Tapashree Ghosh* 1 , Sneha Aggarwal 1 , Arvind Kumar 1 , Radhika Tandon 1 , MA Khan 1
1Dr. R. P. Centre for Ophthalmic Sciences,ALL INDIA INSTITUTE OF MEDICAL SCIENCES,New Delhi,India
Purpose
Deep anterior lamellar keratoplasty (DALK) surgery is now commonly performed in cases advanced corneal ectasia to enable visual rehabilitation and restore the tectonic integrity of the thin cornea. The main aim of this study is to evaluate the long-term outcome of DALK in keratoconus corneas.
Setting
Dr. R. P. Centre for Ophthalmic Sciences, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, New Delhi, India.
Methods
Retrospective study of data of cases of advanced keratoconus that underwent DALK(mean age 22.5+5.1years) and completed a minimum of 6 months follow-up (mean follow-up of 2.96+2.33years, range 6 months to 12 years) was done. Data on demographic details, intraoperative events, postoperative period, visual acuity (UCVA, BCVA)(logmar units), refraction, axial length, corneal topography(with Pentacam) was recorded. Corneal topographic parameters analyzed included Anterior-K1(AK1), Anterior-K2(AK2), Posterior-K1(PK1), PosteriorK2(PK2), Mean keratometry(Kmean), Keratometry maximum (Kmax), Q-value, D-value, Thinnest pachymetry(TP), Corneal elevation [anterior (CE ant) & posterior (CE post)]. 28 patients were sutures-off at the time of assessment.
Results
40 eyes that had undergone DALK [mean age 23.7+10.08)] for advanced keratectasia were included. Mean age at surgery was 19.69+9.64 years (range 7 to 35 years). Mean axial length was 23.7+10.08mm(range 21.01-27.43).Mean preoperative UCVA/BCVA was 1.48+0.36; mean postoperative UCVA/BCVA was 0.83+0.38/0.38+0.23 respectively. Postoperative MRSE was -8.4D(range -0.25 to -11) [mean sphere/cylinder: -3.04D (range -0.5 to -12)/-3.75D (range -0.5 to -7) respectively]. Mean K-max flattened from 81.56+13.96D(range 71.1 to 102.8) to 61.78+10.6D (range 49-94.2) postoperatively. Median value of post-DALK topographic parameters were AK1 44.8D, AK2 51.6D, PK1 6.7D, PK2 8D, K mean 48.1D, Q-value 0.52, D-value 7.79, TP 0.512mm, CE-ant 0.012mm, CE-0.023mm.
Conclusions
DALK surgery helps to restore tectonic integrity with corneal flattening postoperativelywith variable post-DALK astigmatism.