March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Deep Anterior Lamellar Keratoplasty (DALK) With Intraoperative Descemet’s Tears Without Conversion To Penetrating Keratoplasty (PKP)
Author Affiliations & Notes
  • Victor A. Neamtu
    Ophthalmology, University at Buffalo, Buffalo, New York
  • James Chelnis
    Ophthalmology, University at Buffalo, Buffalo, New York
  • Hoon Jung
    Ophthalmology, University at Buffalo, Buffalo, New York
  • Jonathan Soh
    Ophthalmology, University of Rochester, Rochester, New York
  • Footnotes
    Commercial Relationships  Victor A. Neamtu, None; James Chelnis, None; Hoon Jung, None; Jonathan Soh, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 17. doi:
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      Victor A. Neamtu, James Chelnis, Hoon Jung, Jonathan Soh; Deep Anterior Lamellar Keratoplasty (DALK) With Intraoperative Descemet’s Tears Without Conversion To Penetrating Keratoplasty (PKP). Invest. Ophthalmol. Vis. Sci. 2012;53(14):17.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To review cases of completed DALK with intraoperative Descemet's tear without conversion to PKP.

 
Methods:
 

Case series of 3 eyes where DALK was performed for corneal ectasia. All operations were performed by one surgeon. All cases involved intraoperative Descemet’s tears. DALK was completed in all cases.

 
Results:
 

All cases carried the diagnosis of corneal ectasia. Cases 1 and 2 involved fellow eyes of a 41 year-old male with history of LASIK surgery 6 years prior to evaluation. Case 3 involved a 43 year old male with keratoconus who had intracorneal ring segments placed prior to evaluation. All 3 cases involved intraoperative Descemet’s membrane tears that were treated with intracameral air and supine positioning. Case 1 visual acuity (Va) at 42 months follow up was 20/50 (PH 20/30) with a clear graft. Case 2 Va at 5 months follow up was 20/70 (PH 20/40) with focal central edema. Case 3 Va at 12 months follow up was 20/40 with a clear graft. All 3 eyes had a linear or focal posterior scar at the site of rupture. Preoperative photos can be visualized in figure 1 (case 1 slit lamp and Pentacam, case 2 Orbscan, case 3 Orbscan). Postoperative photos are included in figure 2 (case 1 slit lamp and Pentacam, case 2 slit lamp and pachymetry, case 3 Orbscan and OCT).

 
Conclusions:
 

DALK is an effective option for corneal ectasia and may be selectively utilized in cases of Descemet’s membrane tear without necessitating conversion to PKP.  

 

 
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • cornea: endothelium • cornea: clinical science 
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