Kodavoor Shreesha Kumar, Rathi Neha, Dandapani Ramamurthy
Department of Cornea and Refractive Services, The Eye Foundation Hospital, Coimbatore, Tamil Nadu, India.
Department of Cornea, Cataract and Refractive Services, The Eye Foundation Hospital, Coimbatore, Tamil Nadu, India.
Oman J Ophthalmol. 2023 Feb 21;16(1):23-29. doi: 10.4103/ojo.ojo_72_22. eCollection 2023 Jan-Apr.
To analyse complications in patients managed with deep anterior lamellar keratoplasty (DALK) for diseases of anterior corneal stroma.
This was a retrospective analysis of all the patients who underwent DALK in a tertiary care center in South India from 2010 to 2021. A total of 484 eyes in 378 patients were included in the study. Patients who underwent DALK for advanced keratoconus, keratoconus with Bowman's membrane scar, healed hydrops, macular corneal opacity, macular corneal dystrophy, granular corneal dystrophy, spheroidal degeneration, pellucid marginal degeneration, post-LASIK ectasia, descemetocele, postcollagen cross-linking aborted melt and dense scar, and postradial keratotomy were included in the study. The patients were followed up for 17.6±9.4 months(1-10years).
Complications noted in the surgery were intraoperatively Descemet's membrane perforation in 32 eyes (6.6%), postoperatively secondary glaucoma in 16 eyes (3.31%), cataract in 7 eyes (1.45%), suture-related complications in 5 eyes (1.03%), graft rejection in 3 eyes (0.61%), traumatic dehiscence in 2 eyes (0.41%), filamentary keratitis in 2 eyes (0.41%), interface infiltrate in 1 eye (0.21%), and recurrence of disease in 4 eyes (8.77%) out of 57 eyes with corneal dystrophy.
DALK as an alternative to penetrating keratoplasty for anterior corneal stromal diseases has proven to be better time and again. It has become an automatic choice for diseases of anterior cornea requiring keratoplasty. Complications occurring at any stage of surgery can be identified and managed effectively resulting in optimal outcome. This article compiles complications post DALK.
分析接受深板层角膜移植术（DALK）治疗前角膜基质疾病患者的并发症。
这是一项对2010年至2021年在印度南部一家三级医疗中心接受DALK手术的所有患者的回顾性分析。本研究共纳入378例患者的484只眼。接受DALK治疗的患者包括晚期圆锥角膜、伴有Bowman膜瘢痕的圆锥角膜、愈合的角膜水肿、斑状角膜混浊、斑状角膜营养不良、颗粒状角膜营养不良、球形变性、透明边缘变性、准分子激光原位角膜磨镶术（LASIK）后角膜扩张、角膜后弹力层膨出、胶原交联术后失败的角膜溶解和致密瘢痕以及放射状角膜切开术后患者。对患者进行了17.6±9.4个月（1至10年）的随访。
手术中发现的并发症包括32只眼（6.6%）术中后弹力层穿孔，16只眼（3.31%）术后继发性青光眼，7只眼（1.45%）白内障，5只眼（1.03%）缝线相关并发症，3只眼（0.61%）移植排斥反应，2只眼（0.41%）外伤性裂开，2只眼（0.41%）丝状角膜炎，1只眼（0.21%）界面浸润，以及57只角膜营养不良眼中4只眼（8.77%）疾病复发。
DALK作为穿透性角膜移植术治疗前角膜基质疾病的替代方法，已被反复证明效果更好。它已成为需要角膜移植术的前角膜疾病的首选。手术任何阶段出现的并发症都可以被识别并有效处理，从而获得最佳结果。本文汇总了DALK术后的并发症。
