Abstract
Purpose::
To describe the visual and refractive outcomes of deep anterior lamellar keratoplasty (DALK) performed for visual rehabilitation using donor tissue suitable or unsuitable for penetrating keratoplasty (PKP).
Methods::
An observational study of 84 consecutive elective DALK procedures performed for visual rehabilitation. Donor tissue was suitable (31 cases) or unsuitable (53 cases) for PKP.
Results::
Both groups were comparable before surgery with no statistically significant difference in age at time of surgery, sex, indication for surgery, time of follow-up or preoperative visual acuity. The pre-operative best average best-corrected visual acuity (BCVA) was 1.02 (±0.66SD) logMAR (20/209 Snellen) in cases with tissue suitable for PKP and 1.20 (±0.66SD) logMAR (20/317 Snellen) in cases with tissue unsuitable (p=0.3).Average BCVA at 12 months was 0.24 logMAR (±0.24SD) (20/35 Snellen) with tissue suitable for PKP and 0.26 (±0.26SD) logMAR (20/36 Snellen) with tissue unsuitable for PKP (p=0.6) Mean post-operative spherical equivalent was -3.42 (±2.98SD) in those with donor tissue suitable for PKP and -3.52 (±4.10SD) dioptres in those with donor tissue unsuitable for PKP. Mean post-operative refractive astigmatism was -3.8 (±2.20SD) dioptres in those with donor tissue suitable for PKP and -4.3 (±2.20SD) dioptres in those with donor tissue unsuitable for PKP. There were no statistically significant differences in refractive outcomes between the two groups.
Conclusions::
Visual results for deep anterior lamellar keratoplasty using donor tissue unsuitable for penetrating keratoplasty are equivalent to those using tissue, potentially increasing donor tissue availability.
Keywords: transplantation • cornea: clinical science • keratoconus