Pérez PZ, Jareño OM, Fernández GK, Casas AX, Noriega MJL, Fuentes GM

Language: Spanish
References: 10
Page: 1-10
PDF size: 356.50 Kb.

ABSTRACT

Objective: Compare the complications of deep anterior lamellar keratoplasty and penetrating keratoplasty in the surgical treatment of keratoconus.
Methods: An analytical prospective longitudinal study was conducted of 81 patients undergoing keratoplasty and diagnosed with keratoconus. The variables analyzed were cylinder, spherical component, cell density, and preoperative and postoperative complications. Statistical analysis was based on Student's t-test for comparison of means for paired data in the event of two average values.
Results: Cylinder was -3.50 ± 1.50 for deep anterior lamellar keratoplasty and -2.77 ± 0.98 for penetrating keratoplasty. Postoperative cell density was 2 333.6 cell/mm2 for deep anterior lamellar keratoplasty and 2 269.3 cell/mm2 for penetrating keratoplasty. 75% of the patients undergoing deep anterior lamellar keratoplasty and 82.7% of those undergoing penetrating keratoplasty evolved without any complication. The most common complications were microperforation, secondary glaucoma and Urretz-Zavalia syndrome (12.5% each) for deep anterior lamellar keratoplasty, and endothelial rejection (18.2%) and epithelial defect (9.1%) for penetrating keratoplasty.
Conclusions: In deep anterior lamellar keratoplasty endothelial cell loss is slower in the first year and complications are scant.

REFERENCES

1. Keane M, Coster D, Ziaei M, Williams K. Queratoplastia lamelar anterior profunda versus queratoplastia penetrante para el tratamiento del queratocono. Cochrane Database of Systematic Reviews; 2014;7.

2. Cano-Ortiz A, Villarrubia A. Corneal transplantation in keratoconus: penetrating keratoplasty versus deep anterior lamellar keratoplasty with Melles technique. Arch Soc Esp Oftalmol. 2015;90(1):4-8.

3. Hao Liu, Yihui Chen, Peng Wang, Bing Li, Weifang Wang, Yan Su, Minjie Sheng. Efficacy and safety of deep anterior lamellar keratoplasty vs. penetrating keratoplasty for keratoconus: a meta-analysis. PLoS One. 2015;10(1):e0113332.

4. Kubaloglu A, Koytak A, Sogutlu Ari E, Akyol S, Kurnaz E, Ozertuk Y. Corneal endothelium after deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus: A four-year comparative study. Indian J Ophthalmol. 2012;60(1):35-40.

5. Espandar L, Carson AN. Lamellar keratoplasty: a literature review. J Ophthalmol. 2013;2013: 894319.

6. Romano V, Iovieno A. Parente E. Long-term clinical outcomes of deep anterior lamellar keratoplasty in patients with keratoconus. Am J Ophthalmol. 2015;159(3):505-11.

7. Pedrotti E, Passilongo M, Fasolo A, Ficial S, Ferrari S, Marchini G. Refractive outcomes of penetrating keratoplasty and deep anterior lamellar keratoplasty in fellow eyes for keratoconus. Int Ophthalmol. 2017;37(4):911-9.

8. Parker JS, van Dijk K, Melles GR. Treatment options for advanced keratoconus: A review. Surv Ophthalmol. 2015;60(5):459-80.

9. Mohamed SR, Manna A, Amissah-Arthur K, McDonnell PJ. Non-resolving Descemet folds 2 years following deep anterior lamellar keratoplasty: the impact on visual outcome. Cont Lens Ant Eye. 2009;32(6):300-2.

10. Murthy SI, Jain R, Swarup R, Sangwan VS. Recurrent non-tuberculous mycobacterial keratitis after deep anterior lamellar keratoplasty for keratoconus. BMJ Case Rep. 2013;2013. p. 200641.