Influence of Opacity Depth on Big Bubble Formation During Deep Anterior Lamellar Keratoplasty in Corneal Stromal Scars.

Autor:	Lucchino L; Department of Sense Organs, Sapienza - University of Rome, Rome, Italy., Visioli G; Department of Sense Organs, Sapienza - University of Rome, Rome, Italy., Scarinci F; San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli Occhi, Rome, Italy; and., Colabelli Gisoldi RAM; San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli Occhi, Rome, Italy; and., Komaiha C; San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli Occhi, Rome, Italy; and., Giovannetti F; Department of Sense Organs, Sapienza - University of Rome, Rome, Italy., Marenco M; Department of Sense Organs, Sapienza - University of Rome, Rome, Italy., Pocobelli G; Department of Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), University of Rome Tor Vergata, Rome, Italy., Lambiase A; Department of Sense Organs, Sapienza - University of Rome, Rome, Italy., Pocobelli A; San Giovanni Addolorata Hospital, UOC Oftalmologia-Banca degli Occhi, Rome, Italy; and.
Jazyk:	angličtina
Zdroj:	Cornea [Cornea] 2024 Jul 18. Date of Electronic Publication: 2024 Jul 18.
DOI:	10.1097/ICO.0000000000003637
Abstrakt:	Purpose: To identify the key preoperative predictors of big bubble (BB) formation during deep anterior lamellar keratoplasty in patients with corneal stromal scars (CSS). Methods: This retrospective cohort study included consecutive patients with CSS after infective keratitis who underwent BB-deep anterior lamellar keratoplasty between January 2021 and July 2023 at a tertiary referral center. Topographic and tomographic data were collected to compare the rates and types of BB formations. Anterior segment optical coherence tomography (AS-OCT) was employed to assess the maximum depth of opacity by dividing the stroma into 3 zones of equal thickness: anterior (stage A), mid (stage B), and posterior stroma (stage C). Multivariate logistic regression analysis was performed to identify the potential preoperative predictors of bubble formation. Results: Pneumatic dissection was achieved in 13 of 33 eyes (39.4%), with 11 BB type 1 eyes (33.3%) and 2 BB type 2 eyes (6.1%). According to AS-OCT grading, bubble formation was more frequent with CSS involving more superficial stromal layers (P <0.032). In the eyes with stage C, bubble formation failed 12 out of 14 times (85.7%, P <0.026). Spearman correlation showed that bubble formation was inversely associated with the AS-OCT grading (rho = -0.443, P = 0.001). After logistic regression analysis, AS-OCT grading was found to be the sole factor that predicted bubble formation (coeff. -1.58, confidence interval 95% -3.03 to -0.12, P = 0.034). Conclusions: Depth of opacity in CSS was the key determinant for predicting the success of pneumatic dissection, as advanced AS-OCT stages are strongly associated with BB failure. Competing Interests: The authors have no funding or conflicts of interest to declare. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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