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M. Passilongo, E. Bohm, L. Bauchiero, E. Pedrotti, A. Sbabo, G. Soave, G. Marchini; Clinical Outcomes After Deep Lamellar Keratoplasty by Intrastromal Dissection: A Multicentric Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2326.
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The study wants to evaluate clinical outcomes after deep lamellar keratoplasty (DLKP) by intrastromal manual dry dissection, comparing anatomical and functional outcomes on a relevant number of patients operated by different surgeons in 3 north Italian centers. In addiction it wants to verify if there are any surgeon or center-dependent variables.
146 eyes of 142 patients underwent DLKP, 72 in Verona, 47 in Mestre and 27 in Ivrea. After suture removal and late stable clinical situation we evaluated: best corrected visual acuity (BCVA), refraction in spherical equivalent (SE), refractive and topographic cylinder, number of suture adjustments and complications. The statistical evaluation was performed by Student T test with SPSS 13.0 of Windows.
We didn’t find any significant difference among the preoperatory evaluation of 3 groups. Postoperative BCVA of Verona’s group was higher (p< 0,01) than other groups, while SE wasn’t significantly different. We reported a bigger refractive and topographic astigmatism in the samples of Mestre and Ivrea (p<0.05) and more suture adjustments in Verona (64%) than Mestre (6%) and Ivrea (4%). The intraoperative complications were 2 corneal perforations with conversion in penetrating keratoplasty, while the postoperative ones were 10 graft rejections (7 epithelial and 3 stromal), 7 diastasys for suture decubitus, 3 vascularizations and 1 opacity of interface than all resolved.
Surgery outcomes seem surgeon independent. The different BCVA of Mestre and Ivrea seem to depend on a higher residual astigmatism, probably due to a minor suture adjustment. After suture removal, topographic and refractive cylinder become similar, this is related to the effect of the suture on the residual corneal bed.
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