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Outcomes of deep anterior lamellar keratoplasty with Melles technique vs penetrating keratoplasty

Poster Details

First Author: E.Infantes Molina SPAIN

Co Author(s):    J. Celis Sanchez   D. Mesa Varona   E. Avendano Cantos   A. Barrajon Rodriguez   M. Pradas Gonzalez   F. Gonzalez del Valle     

Abstract Details


To describe and compare the visual acuity, refraction, topography, topometry and IOP in eyes that underwent Deep Anterior Lamellar Keratoplasty (DALK) with Melles technique and penetrating keratoplasty (PK).


La Mancha Centro Hospital, Alcázar de San Juan, Ciudad Real. Spain.


A retrospective comparison of consecutive eyes with stromal and epithelial corneal pathology were enrolled. 46 eyes underwent DALK with Melles technique and 69 eyes underwent PK. The keratoplasties were realized by a single surgeon. The topography and topometry were obteined with a Scheimpflug tomographer. The final outcome analysis was performed after two years of surgery. Best corrected visual acuity, spherical equivalent, refractive cylinder, keratometry, corneal astigmatism, asphericity, pachymetry, and endothelial cell density were compared between two groups.


The visual acuity of DALK was 0.53, while in PK was 0.34, differing significantly. The study groups demonstrated comparable final outcome in terms of spherical equivalent (-2.40 vs -0.26 D), refractive cylinder (-4.21 vs -4.46 D), IOP (14.10 vs 15.20mmHg), and endothelial count (1920 vs 1428 cell/mm2), in DALK and PK respectively. On the other hand, there were significant differences in refractive sphere (-0.56 vs 1.84 D), average keratometry (45.03 vs 43.17 D), asphericity (0.29 vs -0.34) and pachymetry (606μ vs 543.3μ), in DALK and PK respectively.


Over two years follow-up after DALK with Melles technique, the vision is higher than PK. The spherical equivalent, refractive cylinder, IOP and endothelial count following DALK and PK were comparable. However, there were significant differences in sphere, average keratometry, asphericity and pachymetry. DALK with Melles technique is an effective alternative surgical procedure for corneal stromal pathologies.

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