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Deep anterior lamellar Keratoplasty
Soliman A Al-Kharashi1, Majed M Al-Obailan, Mansour Almohaimeed
1Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Summary
Deep lamellar keratoplasty (DLKP) offers a safer alternative to penetrating keratoplasty for keratoconus management. This technique avoids intraocular complications and endothelial rejection, providing comparable visual outcomes.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Vision Science
Background:
- Keratoconus is a progressive corneal disease leading to irregular astigmatism.
- Treatment options range from glasses and contact lenses to surgical interventions like keratoplasty.
- Lamellar keratoplasty (LKP) is suitable for moderate to severe keratoconus without deep scarring.
Purpose of the Study:
- To evaluate deep lamellar keratoplasty (DLKP) as a treatment for keratoconus.
- To compare the advantages of DLKP over penetrating keratoplasty (PKP).
Main Methods:
- DLKP involves removing diseased corneal stroma down to Descemet's membrane (DM).
- Partial-thickness donor cornea, without endothelium, is transplanted onto the host bed.
- The procedure avoids violation of intraocular structures.
Main Results:
- DLKP significantly reduces risks of postoperative glaucoma, cataracts, and retinal detachment compared to PKP.
- It eliminates the risk of endothelial graft rejection by preserving host endothelium.
- Visual outcomes are comparable to PKP with a lower rate of endothelial cell loss.
Conclusions:
- DLKP is a highly advantageous surgical option for keratoconus.
- It offers improved safety and comparable visual results to PKP.
- DLKP is recommended for managing keratoconus, especially to avoid intraocular complications.
