Abstract
Purpose: :
to describe anatomical, refractive and visual outcome after microkeratome assisted anterior lamellar keratoplasty. Comparison of the results with a group of 21 eyes after deep anterior lamellar keratoplasty (DALK).
Methods: :
Six eyes were operated with the aid of the Carriazo–Barraquer (CB) microkeratome using baseplate depths ranging from 130 – 300 µm. Donor tissue was prepared with the Moria artificial anterior chamber and the CB microkeratome with baseplate depths from 200 – 350 µm. Patients were followed up at 1 week, 1, 3 and 6 months. Flap thickness was measured at 3 months with a confocal microscope.
Results: :
Flap thickness was 116% (105 – 127%) of the baseplate depth used. Average best spectacle corrected visual acuity (BSCVA) was 0.35 (0.2 – 0.5; SD 0.11) after 1 month and 0.53 (0.3 –0.7; SD 0.2) after 3 months. Spherical equivalent was +0.9 (–1 – +1.75; SD 1.3) before surgery and +1.8 (–0.75 – + 3.5; SD 1.9) at 3 months. Average K was 41 (36.8 – 44.5; SD 3.5) before– and 42 (40.25 – 44; SD 1.7) at 3m postoperatively. Average astigmatism was 1D (0 – 2D; SD 0.7) at 1m and 2.1D (1 – 3; SD 0.9) at 3m. In 2 patients with opacities in the residual bed, hard contact lens VA was 0.4 and 0.25. In the DALK group, BSCVA after an average FU of 35 (12 – 61) months was 0.33 (0.1 – 0.7; SD 0.18).
Conclusions: :
BSCVA recovery is faster and astigmatism lower than after PK. BSCVA results are better than after DALK, probably due to a smoother interface and/or less irregular astigmatism. Opacities left in the residual bed reduced VA more than irregular astigmatism.
Keywords: cornea: clinical science • clinical (human) or epidemiologic studies: outcomes/complications