Retrospective Analysis of Deep Lamellar Keratoplasty for Corneal Dystrophies:

Abstract

Abstract: : Purpose: To study outcomes of corneal stromal dystrophy following deep lamellar keratoplasty. Methods: The medical records of 25 patients 28eyes with corneal stromal dystrophies that had deeplamellar keratoplasty from January 1996 to August 2004 were reviewed retrospectively. Primary pathology, graft clarity, pre– and postoperative best–corrected visual acuity and complications were recorded. Endothelial cell density was measured using a non–contact specular microscope. Results: There were 19 males and 6 females. Mean age was 57.1±14.2 years with a mean follow up of 665±586.7 days. Primary pathology consisted of 7 eyes with granular dystrophy (including Avellino dystrophy), 14 eyes with lattice dystrophy and 7 eyes with macular dystrophy. All 28 eyes showed a postoperative improvement in visual acuity. No rejection episodes have been seen to date. Mean endothelial cell density after 1 year was 1465±926/mm² in patients with granular dystrophy and 2028±722/mm²in patients with lattice dystrophy. Except one eye with granular dystrophy that needed subsequent penetrating keratoplasty due to haze, the other all corneal grafts in patients with granular dystrophy and lattice dystrophy were clear at last follow–up. In contrast, 3 of 5 eyes with macular dystrophy developed endothelial decompensation, and 2 of them had subsequent penetrating keratoplasty. Conclusions: Deep lamellar keratoplasty is a favorable method for granular and lattice dystrophy. However, macular dystrophy may not be a good candidate for deep lamellar keratoplasty, as it might show progressive decrease in the corneal endothelium postoperatively.

Keywords: degenerations/dystrophies • transplantation • clinical (human) or epidemiologic studies: outcomes/complications