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Baek Lok Oh, Mee Kum Kim, Won Ryang Wee; Comparison of Optical Outcomes of Same-Size Grafting between Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty for Keratoconus. Invest. Ophthalmol. Vis. Sci. 2012;53(14):13. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the optical outcomes of same-sized donor grafts between deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PKP).
Medical records of 26 patients were retrospectively reviewed from June 2005 through July 2010. The transplantations consisted of 9 DALK procedures with same-size grafting, 5 PKP procedures with same-size grafting (PKPs), and 12 PKP procedures with 0.25-mm oversize grafting (PKPo) for keratoconus. Best-corrected visual acuity (BCVA), refractive error, corneal topographic profiling, and clinical course were compared between DALK and PKP groups.
At the final follow-up, the DALK and PKP groups achieved a BCVA (logMAR) of 0.23 and 0.46, respectively (P = 0.168). Postoperative spherical equivalent showed moderate myopic astigmatism in both groups without any statistical difference. Mean simulated keratometric index (Sim K) was higher in the DALK group (47.07 D) than in the PKPs group (43.97 D) at 1 year (P = 0.014), a difference that converged at final follow-up. Astigmatism tended to be lower in DALK than in PKPs or PKPo, a difference that was marginally significant. Corneal irregularity indices measured at 3 or 5 mm in the DALK group were less than those in the PKP groups at the final follow-up (P = 0.058 with marginal significance and P = 0.025, respectively).
The optical outcomes of DALK with same-size grafts for keratoconus are comparable to those of PKP. The optical quality might be better in DALK because of less peripheral irregularities.
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