Deep Anterior Lamellar Keratoplasty (Dalk) For Macular Corneal Dystrophy, Three Years Results.

To study the reproducibility, visual outcome, intraoperative and postoperative complications of deep anterior lamellar keratoplasty for macular corneal dystrophy.

Eye city subspecialty center, private practice, all cases were operated by one surgeon in the period between Aug 2017 till December 2020.

Retrospective case series. Twenty seven consecutive eyes of 18 patients were scheduled for deep anterior lamellar keratoplasty for the management of macular corneal dystrophy were included. The outcome measures at 3 years were; Cylinder amplitude, spherical equivalent, corrected distant visual acuity (CDVA), intraoperative and postoperative complications.

20 eyes out of the 27 (74.0%) had a successful big bubble formation, 14 (52.0%) of them were type II bubble and 6 eyes had Type I. 3 eyes (11%) had a manual baring of Descemet’s membrane while 3 eyes (11%) were left with a thin predescemetic residual stromal layer. Microperforation occured in 2 eyes during manual dissectiona. 1 eye had persistent shallow area of DM detachment, 1 eye had marked lipid keratopathy due to deep vascularization that needed regrafting.1 eye (3.7 %) has converted to PK. Average follow up was 24.3 months, corneal cylinder amplitude was 4.6 diopter, spherical equivalent was -2.90 diopter, 20 eyes (74%) had 20/30 or better. Endothelial cell count was 1825 cell/mm, grafts were clear in 20 eyes out of 26 (77.0 %).

Deep anterior lamellar keratoplasty showed to be reproducible, safe and effective in the management of Macular corneal dystrophy, big bubble formation is mainly type II.