Arora Ritu, Jain Pooja, Jain Parul, Manudhane Aditi, Goyal JawaharLal
Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.
Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.
Am J Ophthalmol. 2016 Feb;162:191-198.e2. doi: 10.1016/j.ajo.2015.11.020. Epub 2015 Nov 18.
To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) in children with advanced keratoconus.
Retrospective noncomparative interventional case series.
A retrospective analysis was conducted of 20 eyes of 16 patients who underwent deep anterior lamellar keratoplasty at a tertiary eye care center for advanced keratoconus. The main preoperative parameters measured were decimal uncorrected visual acuity (UCVA), decimal best-corrected visual acuity (BCVA), and average keratometry. The average keratometry was taken as an average of the flat and steep keratometric readings. The follow-up ranged from 24 to 105 months. The main outcome measures were UCVA, BCVA, steep and flat simulated keratometry, refraction, graft clarity, and complications.
At the final follow-up, 18 patients had clear grafts in the visual axis area. Mean decimal UCVA changed from 0.06 ± 0.08 to 0.24 ± 0.09. Mean decimal BCVA changed from 0.12 ± 0.19 to 0.45 ± 0.24. The average keratometry decreased from 64.15 diopter (D) to 45.7 D after surgery. The complications noted in the patients were graft rejection (1), shield ulcers (2), graft infection (2), and interface vascularization (4). They were managed accordingly and only 1 patient needed penetrating keratoplasty.
DALK is an effective therapeutic modality for the management of advanced keratoconus in children.
