Modified Deep Anterior Lamellar Keratoplasty Technique To Rescue Failed Penetrating Keratoplasty
Published 2023 - 41st Congress of the ESCRS
Reference: PO0632 | Type: Free paper | DOI: 10.82333/zb2c-9r30
Authors: Carlos Lisa* 1 , Ricardo Machado-Soares 2 , Luis Fernández-Vega-Cueto 1 , Belén Alfonso-Bartolozzi 1 , José F. Alfonso-Sánchez 1
1Cornea & Lens,Fernandez-Vega Eye Institute,Oviedo,Spain, 2Cornea & Lens,Fernandez-Vega Eye Institute,Oviedo,Portugal
Purpose
To describe a modified deep anterior lamellar keratoplasty (DALK) technique to rescue failed penetrating keratoplasty (PK) grafts and report its results.
Setting
Fernandez-Vega Eye Institute
Methods
Retrospective, case-series analysis of patients who underwent modified DALK to rescue failed corneal grafts after PK was included. Every patient had corneal graft failure (GF) diagnosis due to anterior corneal (epithelium, Bowman’s, and stroma layers) or refraction disorders uncorrectable with conservative management. The main objective of the surgery and primary outcome of the study was the improvement of corrected distance visual acuity (CDVA). The study’s secondary outcome was the frequency of intra- and postoperative complications.
Results
This series included five eyes from four patients with a mean age of 57.7 years (range: 51–63 years). Minimum follow-up of patients was eighteen months (range: 18–36 months). During follow-up, continuous improvement of corneal transparency and CDVA was observed in every patient. The only intraoperative complication reported was a peripheric DM microperforations of previous graft–host junction in two eyes. No signs of double anterior chamber, endothelial failure, GF, glaucoma, or other side effects were reported.
Conclusions
Our results suggest that modified DALK in patients with GF after PK, preserving a healthy endothelium, is surgically feasible. However, further studies are needed to compare this procedure to PK and other DALK technique variations.