Purpose:
To evaluate the effectiveness of superficial anterior lamellar keratoplasty (SALK) in the treatment of anterior stromal dystrophies.
Methods:
This is a retrospective chart review of 22 eyes of 10 patients with anterior stromal corneal dystrophies after they underwent SALK from March 2003 to January 2011 by one surgeon (M Busin, Forli, Italy). Patients were evaluated prior to surgery and clinical diagnosis was recorded. Best corrected visual acuity (BCVA), topographic astigmatism and spheroequivalent were followed prior to and following surgery. Patients were excluded from analysis if preoperative BCVA was not recorded. Demographic data were evaluated using chi-square test. BCVA, topographic astigmatism and spheroequivalent were evaluated using paired sample t-test.
Results:
There were 22 eyes of 10 patients (6 male, 4 female) with a mean age of 47.9 years. Diagnoses included Granular Dystrophy 1 (n=2), Granular Dystrophy 2 (n=11), Lattice Dystrophy (n=2), Reis-Bückler Dystrophy (n=1), or Thiel-Behnke Dystrophy (n=5), with one eye treated for a graft melt.Preoperative BCVA was 20/50 or worse in 21 of 22 eyes. Final visual results were recorded from last postoperative visit with 95% BCVA 20/40 or better and 5 eyes 20/20 or better. BCVA improved significantly within the first 6 months after surgery (p=.004), but no significant improvement was found after that time. The mean preoperative topographic astigmatism was 2.4 (±2.4) D and topographic spheroequivalent was 44 (± 1.8) D. At 36 months, the mean postoperative topographic astigmatism and spheroequivalent had decreased to 1.41 (± 1.5) D and 43.3 (± 2.4) D respectively, but these were not statistically significant findings (p=.4, p=.3).
Conclusions:
SALK has a significant effect in improving vision in patients with stromal corneal dystrophies. The significance of the vision improvement appears to be limited to the first 6 months following surgery.
Keywords: refractive surgery: other technologies • degenerations/dystrophies • cornea: clinical science