Deep Anterior Lamellar Keratoplasty After Previous Anterior Lamellar Keratoplasty to Improve the Visual Outcomes
| Autor: | Caterina Sarnicola, Edoardo Panico, Enrica Sarnicola, Albert Y. Cheung, Vincenzo Sarnicola, Claudio Panico |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Visual acuity genetic structures Vision Disorders Visual Acuity Lamellar keratoplasty Cell Count Refraction Ocular Endothelial cell count Corneal Diseases Corneal Transplantation 03 medical and health sciences 0302 clinical medicine Manual dissection medicine Humans Retrospective Studies medicine.diagnostic_test business.industry Endothelium Corneal Follow up studies Corneal Topography Retrospective cohort study Corneal Endothelial Cell Loss Corneal topography Cannula Surgery Ophthalmology Treatment Outcome 030221 ophthalmology & optometry Female medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Cornea. 40:613-617 |
| ISSN: | 0277-3740 |
| Popis: | Purpose To describe a series of patients who underwent deep anterior lamellar keratoplasty (DALK) after previous anterior lamellar keratoplasty (ALK) to improve their visual outcomes. Methods This is a retrospective case series of 9 DALK eyes (9 patients) with a history of previous ALK and an unsatisfactory visual outcome. Surgery was performed in all cases at least 3 years after ALK. Cannula big bubble, air viscobubble, and manual dissection techniques were performed. Preoperative and postoperative best-corrected visual acuity, residual recipient bed thickness, and endothelial cell count were evaluated. Follow-up was at least 24 months for all eyes. Results Two subtotal anterior lamellar keratoplasties (through 1 type 1 big bubble and 1 air viscobubble) and 7 manual dissection DALKs were achieved. A small rupture of the residual recipient bed occurred during 1 case, and it was managed without penetrating keratoplasty conversion. Mean best-corrected visual acuity improved from 0.64 to 0.09 logMAR. Postoperative residual recipient central bed thickness was less than 80 μm in all cases. No postoperative complications were recorded at the last follow-up (24-36 months postoperatively). Conclusions Different DALK techniques can be successfully used to improve visual acuity in previous ALK eyes with an unsatisfactory visual outcome. |
| Databáze: | OpenAIRE |
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