Long-Term Clinical Outcomes of Deep Anterior Lamellar Keratoplasty in Patients With Keratoconus

Romano, Vito; Iovieno, Alfonso; Parente, Gabriella; Soldani, Anna Maria; Fontana, Luigi

doi:10.1016/j.ajo.2014.11.033

Cited by 99 publications

(66 citation statements)

References 47 publications

(78 reference statements)

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“…4,5 An inverse association between the quantity of transplanted stromal tissue and visual outcome has also been reported in pre-Descemetic deep anterior lamellar keratoplasty. [6][7][8] In addition, we have observed a decreased rate of intraand perioperative (unpublished data) complications when using ultrathin large-diameter DSAEK grafts. Graft diameter is an important variable associated with increased graft survival, 3 and the techniques used to produce an ultrathin DSAEK need to ensure that they are also applicable to producing 9.5-mm graft diameters.…”

Section: To the Editormentioning

confidence: 66%

Ultrathin Grafts for DSAEK With a Single Microkeratome Pass

Romano

Steger

Brunner

et al. 2016

Cornea

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Section: To the Editormentioning

confidence: 66%

Ultrathin Grafts for DSAEK With a Single Microkeratome Pass

Romano

Steger

Brunner

et al. 2016

Cornea

Self Cite

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“…However, DALK has a high risk of perforation in the implanted beds during the operation, and the elastic layer is broken after the postoperative operation. [18] In recent years, femtosecond lasers have been used to produce corneal flaps by precisely cutting the corneal thickness, controlling the occurrence of intraoperative corneal perforation. Mosca et al [19] and Lu Yan et al [20] performed femtosecond laser-assisted DALK in 13 cases of keratoconus and 10 cases with keratoconus, no significant complications during operation or postoperative.…”

Section: Keratoplastymentioning

confidence: 99%

The Current Status and New Research Progress of Keratoconus Treatment

Fengyue¹

2019

IJOVS

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Keratoconus is a common non-inflammatory, bilateral progressive corneal dilatation disease, often leading to progressive thinning of the corneal stromal layer, the central region of the cornea is conical, clinical manifestations of high myopia and irregular astigmatism, The normal life of the patient is greatly inconvenient. Therefore, timely and effective treatment is extremely important to improve the visual quality of patients and their physical and mental health. In the early stage of the patient, vision correction can be performed by wearing a frame mirror or a contact lens; as the lesion progresses, the former is insufficient for correction, and corneal stroma implantation, corneal collagen cross-linking, and keratoplasty are feasible. Numerous studies have confirmed that this treatment can effectively improve and maintain the visual quality of patients. In recent years, new treatment methods such as matrix regeneration, matrix lens transplantation and scleral mirror have gradually become research hotspots at home and abroad. This article reviews the current major treatments for keratoconus and its new developments.

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“…1–3 Unlike PK, DALK preserves the host endothelium and thus eliminates the risk of endothelial rejection, reduces the required duration of corticosteroid therapy, and leads to more rapid wound healing. 4–8 Visual acuity in both PK and DALK are similar, but only if the dissection into the posterior stroma is sufficiently deep in order to prevent the development of tissue interface scarring between the donor cornea and recipient stromal tissue. 10–13 There are numerous techniques to help bare DM, including hydrodelamination, viscoelastic dissection, and anterior chamber air injection.…”

Section: Introductionmentioning

confidence: 99%

Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty

Pasricha

Shieh

Carrasco-Zevallos

et al. 2016

Cornea

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Purpose To examine big bubble (BB) formation success rates in deep anterior lamellar keratoplasty (DALK) at various corneal depths using real-time guidance from swept-source microscope-integrated optical coherence tomography (SS-MIOCT). Methods The DALK procedure was performed ex vivo with 34 human donor corneoscleral buttons on pressurized artificial anterior chambers using Anwar and Teichmann’s BB technique. We inserted a needle under controlled ex vivo conditions to corneal depths ranging from 40–90+% using real-time guidance from SS-MIOCT and injected air. BB success was then determined for each injection. Results The average needle depth for successful full BB formation was 79.9±3.0% compared to 66.9±2.6% for partial BB formation and 49.9±3.4% for no BB formation (P<.0001). Expressed as stroma below the needle tip, this corresponded to 123.9±20.0 µm for successful full BB formation compared to 233.7±23.8 µm for partial BB formation and 316.7±17.3 µm for no BB formation (P<.0001). All other variables tested (gender, race, age, endothelial cell density, air injected, needle angle, and central corneal thickness) did not significantly affect BB formation success rates. Conclusions BB formation in DALK is more successful if needle insertion and air injection occur at deeper corneal depth. However, 90+% corneal depth was not necessary in this ex vivo model of DALK. SS-MIOCT can be used to accurately guide the needle in real-time.

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Long-Term Clinical Outcomes of Deep Anterior Lamellar Keratoplasty in Patients With Keratoconus

Cited by 99 publications

References 47 publications

Ultrathin Grafts for DSAEK With a Single Microkeratome Pass

Ultrathin Grafts for DSAEK With a Single Microkeratome Pass

The Current Status and New Research Progress of Keratoconus Treatment

Needle Depth and Big-Bubble Success in Deep Anterior Lamellar Keratoplasty

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