Al-Torbak Abdullah A
Department of Ophthalmology, College of Medicine, Al-Qasseem University and the Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Saudi J Ophthalmol. 2013 Jan;27(1):11-4. doi: 10.1016/j.sjopt.2012.04.001. Epub 2012 Apr 16.
To present the surgical outcomes of deep anterior lamellar keratoplasty (DALK) for pellucid marginal degeneration (PMD).
A retrospective review was performed in 16 eyes of 16 patients who underwent DALK at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia between January 1, 2006 and December 30, 2009. Baring of Descemet's membrane (DM) during DALK was achieved in 8 (50%) eyes; residual stroma was left intraoperatively in the remaining 8 (50%) eyes. The big bubble technique was performed in 10 (62.5%) eyes and manual dissection was performed in the remaining 6 (37.5%) eyes. Visual acuity (LogMAR notation), intraocular pressure, intraoperative complications and postoperative graft status were assessed.
The mean follow up was 14.6 ± 8.2 months (range 6-35 months). The mean overall age was 31.4 ± 9.6 years (range, 19-50 years). Visual acuity increased statistically significantly from 0.9 ± 0.3 (range 0.5-1.6) preoperatively to 0.4 ± 0.2 (range 0.0-0.7) at last follow-up (p < 0.0001). There was a statistically significant improvement in postoperative sphere, cylinder, and spherical equivalent (p < 0.035, p < 0.001, and p < 0.02, respectively) compared to preoperative. Postoperative visual acuity was not statistically significantly related to gender, type of surgical technique, and baring or perforation of DM. The main graft-related complication was graft-host vascularization (2/16 eyes).
DALK reduces severe corneal astigmatism and results in good visual and refractive outcomes and is an effective alternative for patients with PMD.
介绍深前板层角膜移植术（DALK）治疗透明边缘变性（PMD）的手术效果。
对2006年1月1日至2009年12月30日期间在沙特阿拉伯利雅得国王哈立德眼科专科医院接受DALK手术的16例患者的16只眼进行回顾性研究。8只（50%）眼在DALK术中实现了后弹力层（DM）暴露；其余8只（50%）眼术中保留了残余基质。10只（62.5%）眼采用了大泡技术，其余6只（37.5%）眼采用了手法剥离。评估了视力（LogMAR记录法）、眼压、术中并发症和术后植片情况。
平均随访时间为14.6±8.2个月（范围6 - 35个月）。平均总体年龄为31.4±9.6岁（范围19 - 50岁）。视力从术前的0.9±0.3（范围0.5 - 1.6）统计学显著提高到最后随访时的0.4±0.2（范围0.0 - 0.7）（p < 0.0001）。与术前相比，术后球镜、柱镜和等效球镜有统计学显著改善（分别为p < 0.035、p < 0.001和p < 0.02）。术后视力与性别、手术技术类型以及DM暴露或穿孔无统计学显著相关性。主要的植片相关并发症是植片 - 宿主血管化（2/16只眼）。
DALK可降低严重角膜散光，带来良好的视力和屈光效果，是PMD患者的一种有效替代治疗方法。
