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Deep anterior lamellar keratoplasty using the big-bubble technique in keratoconus
Mohammad-Ali Javadi1, Sepehr Feizi, Hossein Jamali
1Labbafinejad Medical Center, Shahid Beheshti University, MC, Tehran, Iran.
Purpose:
To evaluate the visual outcomes and complications of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in patients with keratoconus.
Methods:
In this case series, 104 eyes of 99 patients with moderate to advanced keratoconus underwent DALK. All subjects were contact lens intolerant or had unacceptable spectacle-corrected visual acuity. DALK was performed using the big-bubble technique. Full thickness donor corneas devoid of Descemet's membrane (DM) were sutured to the recipient bed. Best spectacle-corrected visual acuity (BSCVA), refractive status, and intra- and postoperative complications were evaluated.
Results:
Patients were male in 62.5%. Mean age of patients was 26.2±7.79 (range 15-46) years at the time of DALK and were followed for 23.07±8.1 (range 9-42) months. Mean BSCVA increased from 1.23±0.4 logMAR to 0.26±0.2 logMAR at final follow-up (P<0.001). Postoperative mean spherical equivalent refractive error and refractive and keratometric astigmatism were -3.41±3.1 D, 3.07±2.4 D, and 3.64±2.2 D, respectively. Bared DM was achieved in 86 (82.7%) eyes. Main complications encountered included filamentary keratitis (19.2%), non-endothelial graft rejection (14.4%), and suture abscess (10.6%).
Conclusion:
DALK using the bigbubble technique appears to be a safe and effective procedure in patients with keratoconus.
