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Treatment of post-herpetic corneal stromal opacities with transepithelial topography-guided photorefractive keratectomy and deep anterior lamellar keratoplasty: comparison of clinical and functional results

Poster Details

First Author: N.Maychuk RUSSIA

Co Author(s):    I. Mushkova   R. Makarov                 

Abstract Details


To compare clinical and functional results of Transepithelial Topography – guided Photorefractive Keratectomy (TT-PRK) and Deep Anterior Lamellar Keratoplasty (DALK) in patients with post-herpetic corneal stromal opacities accompanied with low visual acuity (Uncorrected Visual Acuity (UCVA) & Best-Corrected Visual Acuity (BCVA)) and high irregularity of the corneal surface.


Sv. Fyodorov Eye Microsurgery Federal State Institution, Department of Laser Refractive Surgery, Moscow, Russia


Retrospective, comparative analysis of 2 case series included 10 eyes after TT-PRK and 9 eyes after DALK performed because of the low visual UCVA & BCVA due to the post-herpetic corneal stromal opacities not exceeded 2/3 of the corneal thickness. Examination before and 1 year postoperatively included UCVA, BCVA, efficacy, safety, accuracy, spherical and cylindrical components of the refraction, corneal topography (TMS 4, Tomey, Japan), Scheimpflug tomography (Pentacam Oculus, Germany) and optical coherence tomography (Avanti RTVue XR (Optovue, USA)) were performed in all patients. TT-PRK was performed at the excimer laser MicroScan-Visum 500 Hz and KeraScan software (both “OptoSystems”, Russia).


All surgeries were uneventful and no cases of herpetic infection recurrence were noticed. Despite to residual corneal opacities remaining (71.75±25.12 µm) in TT-PRK group UCVA was significantly higher compared to DALK group (0.52±0.03 and 0.23±0.08, respectively) (p = 0.027), with comparable values of BCVA (0.62±0.07 and 0.5±0,13, respectively) (p = 0.461). No lost lines of BCVA were detected. All patients gained lines of UCVA & BCVA (the average gain in lines of UCVA in TT-PRK group was 3.90±0.74, in DALK group was 1.60±0.44; the average gain in lines of BCVA in TT-PRK group was 5.00±1.05, in DALK - 4.00±1.33).


It was shown that both TT-PRK and DALK in patients with post-herpetic corneal stromal opacities up to 2/3 of the corneal thickness accompanied with low visual acuity and high irregularity of the corneal surface - safe and effective methods of refractive rehabilitation, providing highly predictable, stable results and a low complication rate. TT-PRK can be an alternative method to the DALK in comparable noticed selection criteria and provide faster clinical rehabilitation keeping the patients their native corneas.

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