Modified big-bubble technique compared to manual dissection deep anterior lamellar keratoplasty in the treatment of keratoconus

Acta Ophthalmologica
Karl Anders KnutssonGiorgio Paganoni

Abstract

To evaluate the clinical findings and results of manual dissection deep anterior lamellar keratoplasty (DALK) compared to a modified big-bubble DALK technique in eyes affected by keratoconus. Sixty eyes of 60 patients with keratoconus were treated with one of the two surgical techniques manual DALK (n = 30); big-bubble DALK (n = 30). The main outcomes measured were visual acuity, corneal topographic parameters, thickness of residual stroma and endothelial cell density (ECD). Patients were examined postoperatively at 1 month, 6 months, 1 year and 1 month after suture removal. Final best spectacle-corrected visual acuity (BSCVA) measured 1 month after suture removal was 0.11 ± 0.08 LogMAR in the big-bubble group compared to 0.13 ± 0.08 in the manual DALK group (p = 0.227). In patients treated with the big-bubble technique without complications (Descemet's membrane completely bared), the stromal residue was not measureable. Mean stromal residual thickness in the manual DALK group was 30.50 ± 27.60 μm. Data analysis of the manual DALK group demonstrated a significant correlation between BSCVA and residual stromal thickness; lower residual stromal thickness correlated with better BSCVA values (Spearman ρ = 0.509, p = 0.018). Postope...Continue Reading

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Citations

Sep 7, 2016·Acta Ophthalmologica·Marina HesseMatthias Fuest
Mar 23, 2017·Eye & Contact Lens·Matthias Fuest, Jodhbir S Mehta
Nov 7, 2015·European Journal of Ophthalmology·Sepehr FeiziFarid Karimian
Sep 16, 2020·Journal of Cataract and Refractive Surgery·Pratik Y GogriPravin K Vaddavalli

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