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Sayaka Adachi, Yoshiyuki Ichihashi, Tetsuya Kawakita, Yukihiro Matsumoto, Kazuo Tsubota, Shigeto Shimmura; Clinical Results of Deep Anterior Keratoplasty by the Visco-dissection Technique. Invest. Ophthalmol. Vis. Sci. 2011;52(14):785.
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© ARVO (1962-2015); The Authors (2016-present)
To report the mid-term result of deep anterior keratoplasty(DALK) by the visco-dissection technique.
Eighteen eyes of 22 patients (12 men and 6 women) with leukoma(11 eyes) , keratoconus(5 eyes), cornea dystrophy(4 eyes),and cornea infection(2 eyes)were examined retrospectively. All cases were operated by the same surgeon (S. S.) at the Keio University Hospital using the viscodissection technique. We investigated visual acuity, spherical equivalent (SE) and endothelial cell density up to 12 months.The average follow-up period was 14.2±9.0 months.
Five eyes (22.7%) were converted to penetrating keratoplasty due Descemet’s membrane tears, mostly in the initial cases. Mean preoperative best-corrected visual acuity was 0.85±0.63 logMAR, and postoperatively, 0.35±0.48 logMAR at 3 months, 0.34±0.60 logMAR at 6 months, and 0.08±0.28 logMAR at 12 months. There was significant improvement in vision (p<0.05). Mean postoperative SE was -3.21±5.29D preoperatively, -4.76±4.81D at 3 months, -5.25±5.70D at 6 months, and -7.58±6.04 at 12 months after DALK showing a slight myopic shift which was not statistically significant. Mean loss of donor endothelial cell density was 24.0% at 3 months, and 26.0% at 12 months.
This retrospective study shows that visco-dissection DALK has a steep learning curve, but offers significant improvement in vision with no significant refractive change and mild endothelial cell loss.
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