Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty for Keratoconus: A Clinical Trial

Javadi, Mohammad Ali; Feizi, Sepehr; Yazdani, Shahin; Mirbabaee, Firooz

doi:10.1097/ico.0b013e3181b81b71

Cited by 106 publications

(87 citation statements)

References 28 publications

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“…In this series, a single running suture was used in all of the treatment groups, and there were no differences in the time of suture removal between different groups; this result differed from other studies [3,5]. Because a loose suture or vascularization of the host cornea is more frequent in patients with DALK, the sutures were removed earlier in DALK than PK in these studies [3,5,18,19]. The difference between the current and previous studies might be related to suture techniques.…”

Section: Discussioncontrasting

confidence: 82%

“…Other surgical factors that can influence the postoperative refractive errors are suture techniques and the time of suture removal [11][12][13]. In this series, a single running suture was used in all of the treatment groups, and there were no differences in the time of suture removal between different groups; this result differed from other studies [3,5]. Because a loose suture or vascularization of the host cornea is more frequent in patients with DALK, the sutures were removed earlier in DALK than PK in these studies [3,5,18,19].…”

Section: Discussionmentioning

confidence: 53%

“…Furthermore, DALK preserves the patient's own endothelial layer, which to some extent reduces the incidence of immunologic reactions [3,6]. However, other studies found that DALK is not superior to PK [7,8], given that DALK yields a higher rate of myopia after surgery [3,5,8,9]. For advanced keratoconus patients, myopic tendencies after DALK, along with preoperative preexisting refractive issues may highlight the refractive irregularities; therefore, it may be difficult to achieve optimal visual acuity.…”

Section: Introductionmentioning

confidence: 95%

“…There is increasing evidence that the clinical outcomes are comparable between DALK and PK for the treatment of advanced keratoconus [3,5]. Furthermore, DALK preserves the patient's own endothelial layer, which to some extent reduces the incidence of immunologic reactions [3,6].…”

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

Comparison of refractive outcomes in three corneal transplantation techniques for keratoconus

Huang

Gui

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 98%

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Comparison of refractive outcomes in three corneal transplantation techniques for keratoconus

Huang

Gui

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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“…Therefore, DALK can eliminate the risk of endothelial graft rejection and has minimal detrimental effect on endothelial cell density [2]. Some investigators report that visual acuity and refractive error following DALK can be similar to those following PK [3][4][5][6]. Since the introduction of DALK, many surgeons have been accepting donor corneas with lower quality compared with PK.…”

Section: Introductionmentioning

confidence: 99%

Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

Feizi¹

2016

Advances in Eye Surgery

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Deep anterior lamellar keratoplasty (DALK) has been recently introduced as an alternative to penetrating keratoplasty (PK) for corneal pathologies not involving corneal endothelium. DALK does not rely on donor endothelium and requires less rigid criteria for donor corneal tissue quality. Therefore, it provides a greater availability of donor corneas that do not need perfectly healthy endothelium and high endothelial cell density to be suitable for PK. Furthermore, as lamellar corneal surgery expands the potential use of acellular corneal tissue, long-term preservation techniques are being revisited as a way to increase availability of corneal tissue to alleviate constraints of availability, cost, storage, and transportation in many countries. The recent alterations in the technique of corneal transplantation and hence the type of donor cornea tissues used for each technique, may require eye banks and corneal surgeons to reassess their selection criteria but it is important for any changes to be evidence-based. The purpose of this chapter, therefore, is to present an updated analysis on the type and quality of donor corneas used for PK and DALK, to evaluate the impact of donor and eye bank variables on the suitability of corneas for transplantation and then go on to determine whether any of these donor factors affect clinical outcomes, complications, and graft survivals.

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Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus

Keane

Coster

Ziaei

et al. 2014

Cochrane Database of Systematic Reviews

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Analysis 1.2. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 2 Postoperative BCVA (varied follow-up times, post-suture removal) (LogMAR).. .. .. .. .. .. Analysis 1.3. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 3 Postoperative functional BCVA achieved (varied follow-up times, post-suture removal).. .. .. .. . Analysis 1.4. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 4 Postoperative UCVA (varied follow-up times, post-suture removal) (LogMAR).. .. .. .. .. .. Analysis 1.5. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 5 Postoperative functional UCVA achieved (varied follow-up times, post-suture removal).. .. .. .. . Analysis 1.6. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 6 Postoperative keratometric astigmatism (varied follow-up times, post-suture removal) (D).. .. .. .. Analysis 1.7. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 7 Postoperative spherical equivalent (varied follow-up times, post-suture removal) (D).. .. .. .. .. Analysis 1.8. Comparison 1 Deep anterior lamellar keratoplasty (DALK) versus penetrating keratoplasty (PK), Outcome 8 Postoperative keratometric astigmatism (12 months

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Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty for Keratoconus: A Clinical Trial

Abstract: DALK is an effective alternative surgical procedure for patients with keratoconus; the outcomes are comparable to PK in terms of refractive errors, BCVA, CSF, and HOAs.

Cited by 106 publications

References 28 publications

Comparison of refractive outcomes in three corneal transplantation techniques for keratoconus

Comparison of refractive outcomes in three corneal transplantation techniques for keratoconus

Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus

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