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Deep Anterior Lamellar Keratoplasty for the Treatment of Stromal Corneal Dystrophies

Ünal, Mustafa MD; Arslan, Osman Ş. MD; Atalay, Eray MD; Mangan, Mehmet S. MD; Bilgin, Ahmet B. MD

doi: 10.1097/ICO.0b013e31825718ca
Clinical Science

Purpose: To report the perioperative complications and clinical outcomes after deep anterior lamellar keratoplasty (DALK) using the big bubble technique in eyes with stromal corneal dystrophies.

Patients and Methods: Seventy-four eyes of 65 patients who underwent DALK for stromal corneal dystrophies were evaluated in this retrospective interventional case series study. Main outcome measures were intraoperative and postoperative complications, postoperative uncorrected visual acuity, best spectacle–corrected visual acuity, spherical equivalent refraction, and topographic astigmatism.

Results: There were 44 eyes with macular corneal dystrophy, 18 eyes with lattice dystrophy, and 12 eyes with granular dystrophy. DALK was completed in 69 cases (94.6%). Descemet membrane microperforations occurred in 6 eyes (8.7%). The mean follow-up period was 43.5 ± 23.9 months, ranging from 12 to 96 months. Postoperative best spectacle–corrected visual acuity of 0.5 or better was present in 52 of 69 eyes (75.4%). There were 3 episodes of stromal graft rejection, which responded to topical therapy. Lattice dystrophy recurred in 6 eyes (35.3%).

Conclusion: DALK using the big bubble technique is an effective procedure in the treatment of patients with corneal stromal dystrophies. Recurrence of lattice dystrophy was relatively high.

*Department of Ophthalmology, Akdeniz University School of Medicine, Antalya, Turkey

Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

Reprints: Mustafa Ünal, Department of Ophthalmology, Akdeniz University, Antalya, Turkey (e-mail:

M. Ünal was supported by Akdeniz University Scientific Research Projects Unit.

Presented as a free paper in 2nd EuCornea Congress, September 17–21, 2011, Vienna, Austria.

The authors state that they have no financial support or financial/conflict of interest involved in the design of the study; conduct of the study; collection, management, analysis, and interpretation of the data; and preparation of the article.

Received January 4, 2012

Accepted March 23, 2012

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