Mathur Vijay, Parihar J K S, Srivastava V K, Avasthi A
Senior Adviser (Ophthalmology), Base Hospital, Delhi Cantt, New Delhi 110010, India.
Consultant (Ophthalmology), Army Hospital (R&R), New Delhi, India.
Med J Armed Forces India. 2013 Jan;69(1):21-6. doi: 10.1016/j.mjafi.2012.04.023. Epub 2012 Aug 30.
Corneal scars are commonly formed following many diseases of the eye like trauma, inflammation and infections. They lead to permanent diminution of vision which can be managed by Penetrating Keratoplasty (PK). PK is removing diseased as well as healthy tissues and is associated with many post-operative complications. Deep Anterior Lamellar Keratoplasty (DALK) is a relatively newer procedure which replaces only the diseased stroma, leaving the original corneal endothelium intact. This procedure is associated with lesser incidence of post-operative complications.
The study was conducted at a large tertiary care centre. 10 patients with stromal corneal scars were subjected to DALK and results were analysed after 06 months. Poor quality donor corneal tissue of B- and C grade was used in all cases.
7 out of 10 patients (70%) undergoing DALK had post-operative visual acuity of 6/24 or better. 03 patients who did not have adequate recovery of visual acuity were due to over-riding of the graft in 01 case (10%), fungal keratitis in 01 case (10%) and interface haze in 01 case (10%).
DALK is a promising new technique for management of superficial corneal stromal scars using poor quality donor corneal tissue. Initial results are encouraging with minimal complications.
角膜瘢痕通常在许多眼部疾病如外伤、炎症和感染后形成。它们会导致视力永久性下降，可通过穿透性角膜移植术（PK）进行治疗。PK会切除病变组织以及健康组织，且伴有许多术后并发症。深板层角膜移植术（DALK）是一种相对较新的手术，仅替换病变的基质，保留原始角膜内皮完整。该手术术后并发症发生率较低。
本研究在一家大型三级护理中心进行。10例角膜基质瘢痕患者接受了DALK手术，并在6个月后分析结果。所有病例均使用质量较差的B级和C级供体角膜组织。
10例接受DALK手术的患者中，7例（70%）术后视力达到6/24或更好。3例视力恢复不佳的患者，1例（10%）是由于移植片覆盖，1例（10%）是由于真菌性角膜炎，1例（10%）是由于界面混浊。
DALK是一种使用质量较差的供体角膜组织治疗浅层角膜基质瘢痕的有前景的新技术。初步结果令人鼓舞，并发症极少。
