Clinical Outcome of Deep Anterior Lamellar Keratoplasty Using Hydrodissection Technique for Keratoconus

Abstract

Purpose: : To evaluate the visual outcome and intra- and post-operative complication of deep anterior lamellar keratoplasty (DLKP) in patients with keratoconus

Methods: : Five patients who were diagnosed as havingadvanced keratoconus underwentDLKP. Donor cornea devoid of endothelium and Descemet membrane was transplanted onto a recipient bed after deep lamellar dissection using hydrodissection technique and removal of recipient stroma. The main outcome measures included visual acuity, refractive error, topographic astigmatism, and presence of intra- and post-operative complications.

Results: : The mean age of the patients was 23.6 years (range : 19~26 years). There was no intraoperative complication in al cases. The mean postoperative follow-up period was 12 months (range : 7~19months). The mean postoperative visual improvement was five lines of Snellen visual acuity and all patients achieved best-corrected visual acuity of 20/40 or better at the end of follow-up period. Postoperative topographic astigmatism ranged from 3.6 to 8.1D. During the follow-up period, transient elevation of intraocular pressure was noted in one patient. No case of graft rejection was observed.

Conclusions: : DLKP using hydrodissection technique is a good option for the primary surgery in patients with advanced keratoconus.

Keywords: keratoconus • cornea: stroma and keratocytes