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Changes in Central Macular Thickness After Uncomplicated Corneal Transplantation for Keratoconus: Penetrating Keratoplasty Versus Deep Anterior Lamellar Keratoplasty

Koytak, Arif MD; Kubaloglu, Anil MD; Sari, Esin Sogutlu MD; Atakan, Mehmet MD; Culfa, Safak MD; Ozerturk, Yusuf MD

doi: 10.1097/ICO.0b013e31821eeaad
Clinical Science

Purpose: The aim of this study was to assess changes in macular thickness by means of optical coherence tomography after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) for keratoconus.

Methods: This prospective study comprised 60 eyes of 60 patients who had keratoplasty for the treatment of keratoconus. Eyes were divided into 2 groups according to the keratoplastic technique applied: PKP group and DALK group. Measurements of central macular thickness were performed preoperatively and 1, 3, and 6 months after surgery.

Results: The final analysis included 33 eyes in the PKP group and 24 eyes in the DALK group. In the PKP group, the central macula was found to be 6.5%, 6.3%, and 4.5% thicker in the first, third, and sixth month, respectively. Similarly, the central macula was 5.6%, 5.4%, and 2.9% thicker at months 1, 3, and 6 in the DALK group. The 2 groups did not differ significantly in terms of macular thickening. The percentage of eyes showing more than 10% increase in the macular region at any time during the follow-up period was 43.2% in the PKP group and 50.0% in the DALK group (P = 0.614). The percentage of eyes found to have a central macular thickness more than 250 μm at any time during the follow-up period was 10.8% in the PKP group and 18.2% in the DALK group (P = 0.424).

Conclusions: The study showed that DALK, although it is a closed-system technique, has a similar impact on the macula compared with PKP.

From the *Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University; and †Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey.

Received for publication November 20, 2010; revision received March 13, 2011; accepted April 10, 2011.

None of the authors have received financial support for this study.

None of the authors have any financial or proprietary interest in the products, methods, or materials mentioned in this article.

Reprints: Arif Koytak, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvari 34093, Fatih, Istanbul, Turkey (e-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.