Visual acuity outcomes after deep anterior lamellar keratoplasty: a case-control study

Area of Science:

• Ophthalmology
• Corneal Surgery
• Transplantation

Background:

• Corneal transplantation is a common procedure for vision restoration.
• Deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) are surgical options.
• Comparing outcomes of different keratoplasty techniques is crucial for patient care.

Purpose of the Study:

• To compare visual and refractive outcomes between DALK and PK.
• To evaluate complications and graft survival rates for each procedure.
• To determine the preferred keratoplasty technique for specific corneal conditions.

Main Methods:

• Retrospective case-control study.
• Evaluated visual acuity (VA) in 51 eyes undergoing DALK with complete Descemet's baring (DALKa), 52 eyes undergoing pre-descemetic anterior lamellar keratoplasty (DALKm), and 103 eyes undergoing PK.
• Mean follow-up periods were 13.6, 19.3, and 18.6 months, respectively.

Main Results:

• Best-corrected VA of 6/7.5 or better achieved in 38.5% of DALKa, 21.6% of DALKm, and 19.4% of PK cases (p=0.02).
• DALKa showed significantly better visual outcomes than PK (p=0.03).
• Two-year graft survival was 100% for DALKa, 98% for DALKm, and 90% for PK.

Conclusions:

• Lamellar keratoplasty with complete Descemet's baring (DALKa) yields superior visual outcomes compared to PK and pre-descemetic ALK.
• DALKa should be the preferred corneal replacement method for disorders with a healthy endothelium.
• DALKa demonstrates excellent graft survival rates.