Official ESCRS | European Society of Cataract & Refractive Surgeons


Factors predictive of double anterior chamber formation following deep anterior lamellar keratoplasty

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Session Details

Session Title: Cornea Surgical: Lamellar Corneal Grafts

Session Date/Time: Tuesday 17/09/2019 | 08:30-10:30

Paper Time: 08:48

Venue: Free Paper Forum: Podium 3

First Author: : G.Salsini ITALY

Co Author(s): :    J. Myerscough   C. Bovone   M. Mimouni   M. Elkadim   S. Padroni   M. Busin              

Abstract Details


To identify risk factors predictive of postoperative double anterior chamber formation after deep anterior lamellar keratoplasty (DALK)


Retrospective institutional cohort study. All consecutive eyes undergoing primary DALK between May 2015 and October 2018 at Villa Igea private hospital (Forli, Italy).


Indications for surgery were categorized as 1) Keratoconus without scarring; 2) Keratoconus with scarring 3) Non-keratoconus without scarring; and 4) Non-keratoconus with scarring. Multivariate binary logistic regression analysis was performed, introducing, as independent variables, those that reached a significance level of less than 0.05 in univariate analysis. The main outcome measure was whether or not postoperative double anterior chamber (AC) occurred.


591 eyes were included. The main indication for DALK was keratoconus (67.2%), and pneumatic dissection was achieved in 72.9% of patients. Postoperative double AC was observed in 8.1% of cases. Age, intraoperative central DM perforation, type 2 bubble formation, and presence of scar were all associated with an increased risk of postoperative double AC formation in the univariate analysis. Manual dissection was not associated with double AC formation. Factors remaining significant in multivariate analysis were keratoconus with scarring (OR=3.56, p=0.02), non-keratoconus with scarring (OR=5.09, p=0.002), intraoperative central perforation (OR=6.09, p=0.03) and type 2 bubble formation (OR=14.17, p<0.001).


Scarred corneas of both normal and abnormal shape are independent risk factors for double AC formation following DALK, along with intraoperative perforation and the occurrence of a type 2 bubble.

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