Pellegrini Marco, Yu Angeli Christy, Busin Massimo
Department of Translational Medicine, University of Ferrara, Forlì, Italy.
Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy.
Saudi J Ophthalmol. 2022 Jul 11;36(1):36-41. doi: 10.4103/sjopt.sjopt_100_21. eCollection 2022 Jan-Mar.
Advanced keratoconus may require keratoplasty when the patient can no longer achieve functional vision with glasses and contact lenses. Deep anterior lamellar keratoplasty (DALK) has become the surgical treatment of choice due to its undisputed advantages over penetrating keratoplasty including the reduced risk of intraoperative complications, the absence of endothelial immune rejection, and the longer graft survival. Albeit "big-bubble" DALK still represents the most popular surgical method, several modifications have been developed over the years. This allowed standardization of the technique, with improved success rates and clinical outcomes. This review presents an overview on the literature on DALK surgery for keratoconus. We discuss state-of-the art surgical techniques, current evidence on the clinical outcomes and complications as well as possible future directions.
当圆锥角膜病情发展到晚期，患者无法通过眼镜和隐形眼镜获得功能性视力时，可能需要进行角膜移植手术。与穿透性角膜移植术相比，深板层角膜移植术（DALK）具有术中并发症风险降低、无内皮免疫排斥反应以及移植片存活时间更长等无可争议的优势，已成为首选的手术治疗方法。尽管“大泡”DALK仍然是最常用的手术方法，但多年来也发展出了多种改良术式。这使得该技术得以标准化，成功率和临床效果均有所提高。本文综述了有关圆锥角膜DALK手术的文献。我们讨论了当前的先进手术技术、临床效果和并发症的现有证据以及可能的未来发展方向。
