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Indications and Outcome of Optical Partial Thickness Lamellar Keratoplasty

Saini, Jagjit S. M.D.; Jain, Arun K. M.D.; Sukhija, Jaspreet M.S.; Saroha, Vandana M.S.

Clinical Sciences

Purpose. To review the indications and outcome of optical partial thickness lamellar keratoplasty (LKP) over a 22-year period.

Methods. The study is a retrospective review of 138 eyes of 126 patients. Snellen visual acuity, preoperative clinical condition, and postoperative clinical status were assessed.

Results. Postoperative follow-up ranged from 1 month to 174 months (average, 34.5). In descending order of frequency, climatic droplet keratopathy, infectious keratitis scar, and band-shaped keratopathy were the most common indications for surgery. Follow-up records were available for 130 eyes; 93% of grafts remained transparent. One hundred eyes (80%) preoperative measured Snellen acuity of 6/60 or less. Postoperatively, only 20 eyes (13.4%) were assessed as worse than 6/60. Mean best-corrected visual acuity postoperative was 0.58 ± 0.24. Twenty-two eyes (16.9%) demonstrated postoperative visual acuity of better than 6/12. Complications included presumed rejection in two eyes, nonhealing epithelial defect in two eyes, and graft infection in seven eyes.

Conclusion. Vision gain following LKP is generally moderate (visual acuity, 6/18–6/12) in the majority of eyes (61.5%). Vision-threatening complications are low (6.9%). There is scope for reducing complications like postoperative infections and improving visual gain through deep lamellar keratoplasty.

From the Cornea and External Diseases Section, Advanced Eye Center (Department of Ophthalmology), Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Submitted April 23, 2002.

Revision received October 29, 2002.

Accepted October 29, 2002.

Address correspondence and reprint requests to Jagjit S. Saini, M.D., Advanced Eye Center (Department of Ophthalmology), Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. E-mail: jssainichd@yahoo.com

© 2003 Lippincott Williams & Wilkins, Inc.