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