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Deep Anterior Lamellar Keratoplasty

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https://www.readbyqxmd.com/read/28405478/comparison-of-outcomes-in-patients-who-underwent-deep-anterior-lamellar-keratoplasty-and-those-converted-to-penetrating-keratoplasty
#1
Yusuf Koçluk, Emine Alyamaç Sukgen, Ayşe Burcu
OBJECTIVES: To compare clinical outcomes of cases who underwent deep anterior lamellar keratoplasty (DALK) and cases who were converted to penetrating keratoplasty (PKP) from DALK surgery. MATERIALS AND METHODS: The records of 54 patients for whom DALK surgery was planned and were operated for different diagnoses between March 2013 and June 2015 were retrospectively analyzed. Patients were divided into two groups: group 1 (PKP group) consisted of 23 cases who were converted to PKP due to Descemet's membrane perforation at any stage of surgery; group 2 (DALK group) consisted of 31 patients whose surgery could be completed as DALK...
April 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28393029/comparison-of-visual-and-topographic-outcomes-of-deep-anterior-lamellar-keratoplasty-and-penetrating-keratoplasty-in-keratoconus
#2
Bora Yüksel, Baran Kandemir, Umut Duygu Uzunel, Ozan Çelik, Sezgin Ceylan, Tuncay Küsbeci
AIM: To compare visual, surgical and topographic outcomes of deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) for keratoconus (KC). METHODS: In this multicenter, prospective, randomized clinical trial 76 eyes of 71 KC patients operated between January 2011 and July 2014 in 2 tertiary referral hospitals were included. Consecutive patients were alternately selected to receive one of the two surgical methods. Thirty eight eyes underwent DALK with the big-bubble technique and 38 eyes underwent PK...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28387767/femtosecond-laser-assisted-in-situ-keratomileusis-for-the-correction-of-residual-ametropia-after-deep-anterior-lamellar-keratoplasty-a-pilot-investigation
#3
A Balestrazzi, A Balestrazzi, F Menicacci, G Cartocci, F Menicacci, P Michieletto, E Balestrazzi
PurposeTo evaluate the refractive and visual results of one-stage laser-assisted in situ keratomileusis with femtosecond laser (Femto-LASIK) for the correction of residual ametropia after deep anterior lamellar keratoplasty (DALK).MethodsThis retrospective study included 13 eyes of 12 patients, who underwent corneal Femto-LASIK to correct refractive errors after DALK. IntraLase FS150 was used to create a lamellar flap and excimer laser ablation for refractive correction was performed using the Star S4 IR Excimer Laser in eight cases and the Technolas 217z Excimer Laser in Tissue Saving mode in five cases...
April 7, 2017: Eye
https://www.readbyqxmd.com/read/28355171/glaucoma-mini-shunt-implantation-after-keratoplasty
#4
Jasbeth Ledesma-Gil, María de Los Ángeles García-Rodríguez, Lulu U Gurria, Enrique O Graue-Hernández, Alejandro Navas
PURPOSE: To report the outcomes of patients who underwent miniature glaucoma shunt implantation after secondary glaucoma due to keratoplasty. MATERIALS AND METHODS: Prospective study of consecutive clinical cases who underwent mini-glaucoma shunt implantation following keratoplasty. In brief, a fornix-based conjunctival flap was performed, approximately 50% thickness scleral flap. Mitomycin C 0.025% placed under Tenon's capsule. A 25-G needle created entry for mini-shunt...
April 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28345566/intraoperative-optical-coherence-tomography-in-anterior-segment-surgeries
#5
Jeewan S Titiyal, Manpreet Kaur, Ruchita Falera
Intraoperative optical coherence tomography (iOCT) is a noninvasive imaging modality that provides a real-time dynamic feedback of the various surgical steps. Comprehensive literature search was performed in MEDLINE using "intraoperative optical coherence tomography" and "iOCT" as keywords. The use of iOCT as an aid to decision-making has been successfully reported in cases undergoing keratoplasty, implantable Collamer lens (ICL) implantation as well as cataract surgery. iOCT helps to assess the graft-host relationship in penetrating keratoplasty...
February 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28337067/late-spontaneous-resolution-of-a-double-anterior-chamber-post-deep-anterior-lamellar-keratoplasty
#6
Andrea Passani, Angela Tindara Sframeli, Pasquale Loiudice, Marco Nardi
A 31-year-old healthy male underwent deep anterior lamellar keratoplasty with big-bubble technique for treatment of keratoconus in his right eye. One week after surgery, he presented with detachment of the endothelium-Descemet complex with formation of a double anterior chamber, despite the apparent absence of an intraoperative Descemet membrane rupture. A subsequent intervention with the intent to relocate the corneal graft button was not effective, because the detachment appeared again one day later. The authors hypothesized that, at the time of the stromal dissection with big bubble technique, a small amount of air penetrated into the anterior chamber, creating a false pathway through the trabecular meshwork...
January 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28336058/large-9-mm-deep-anterior-lamellar-keratoplasty-with-clearance-of-a-6-mm-optical-zone-optimizes-outcomes-of-keratoconus-surgery
#7
Massimo Busin, Pia Leon, Yoav Nahum, Vincenzo Scorcia
PURPOSE: To evaluate the outcomes of a 9-mm deep anterior lamellar keratoplasty (DALK) with removal of the deep stroma limited to the central 6-mm optical zone. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: A total of 80 consecutive keratoconic eyes without deep stromal scarring, with at least 1 postoperative examination 1 month after complete suture removal. INTERVENTION: A standardized DALK was performed, including (1) deep trephination of the recipient bed 450 to 550 μm in depth and 9 mm in diameter; (2) pneumatic dissection; (3) debulking of approximately 80% of the anterior stroma; (4) removal of the deep stroma (bubble roof) from a central 6-mm optical zone; and (5) transplantation of a 9-mm anterior corneal lamella cut by microkeratome-assisted dissection (400-μm head) and sutured with a double running 10-0 nylon suture...
March 20, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28328727/strategies-for-deep-anterior-lamellar-keratoplasty-after-hydrops-in-keratoconus
#8
Matthias Fuest, Jodhbir S Mehta
Corneal hydrops affects approximately 2.5% of keratoconus (KC) cases, predominantly young males approximately 25 years of age with steep cones. Often, patients are left with a vision-reducing corneal scar frequently necessitating surgical treatment. Penetrating keratoplasty (PK) has worse survival outcomes in hydrops than in general KC cases. Deep anterior lamellar keratoplasty (DALK) is a nonpenetrating technique believed to achieve equal or better outcomes in visual acuity, graft survival, endothelial rejection rates, and endothelial cell survival in comparison with PK, while maintaining globe integrity and the patients' Descemet membrane (DM) and endothelium...
March 21, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28316189/-noteworthy-and-controversial-problems-of-deep-anterior-lamellar-keratoplasty
#9
H Gao
Corneal transplant is the main treatment for blindness caused by corneal diseases. The common methods of corneal transplant include penetrating keratoplasty and lamellar keratoplasty. With the advances of microsurgical instruments and technology in recent years, deep anterior lamellar keratoplasty (DALK) has gradually increased. Compared with conventional penetrating keratoplasty, the optical effects of DALK are not much different, but DALK has fewer complications. So DALK is expected to become the mainstream of corneal transplantation...
March 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28300735/comparison-of-femtosecond-laser-assisted-descemetic-and-predescemetic-lamellar-keratoplasty-for-keratoconus
#10
Yan Lu, Ana Beatriz Diniz Grisolia, Yi-Rui Ge, Chun-Yan Xue, Qian Cao, Li-Ping Yang, Zhen-Ping Huang
PURPOSE: The purpose of this study is to compare the outcomes following femtosecond laser-assisted deep anterior lamellar keratoplasty (DALK) with 75% of stromal dissection (predescemetic group) and femtosecond laser-assisted DALK using big-bubble technique with total stromal resection (descemetic group) for the treatment of keratoconus. SUBJECTS AND METHODS: Twenty eyes of 17 patients with keratoconus were studied. There were 10 eyes of 9 patients in predescemetic group and 10 eyes of 8 patients in descemetic group...
January 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28257387/repeat-keratoplasty-for-failed-deep-anterior-lamellar-keratoplasty-in-keratoconus-incidence-indications-and-outcomes
#11
Sepehr Feizi, Mohammad Ali Javadi, Pejman Khajuee-Kermani, Roya Jafari
PURPOSE: To analyze the incidence, indications, and clinical outcomes of penetrating keratoplasty (PK) and repeat deep anterior lamellar keratoplasty (DALK) after failed DALK for keratoconus. METHODS: This retrospective interventional case series reviewed the medical records of patients with keratoconus who underwent DALK and were followed up for at least 1 year. Patients who underwent PK or repeat DALK for failed DALK were identified. The incidence, indications, and clinical outcomes after repeat keratoplasty were assessed...
May 2017: Cornea
https://www.readbyqxmd.com/read/28237153/current-indications-and-surgical-approaches-to-corneal-transplants-at-the-university-of-toronto-a-clinical-pathological-study
#12
Ryan Le, Narain Yucel, Shireen Khattak, Yeni H Yucel, Gerald J Prud'homme, Neeru Gupta
OBJECTIVE: To determine the most common reasons and surgical approaches for corneal graft surgery at the Kensington Eye Institute (KEI), University of Toronto. DESIGN: Retrospective cross-sectional study. PARTICIPANTS: A total of 229 consecutive corneal transplants performed at the KEI. METHODS: Demographic, clinical, and pathological data on all 2012 and 2013 corneal transplants were collected. RESULTS: The mean age for corneal transplants was 65 ± 16 years; 39% were full-thickness penetrating keratoplasties (PK) and 61% were partial-thickness...
February 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28237152/patient-comfort-and-visual-outcomes-of-mini-scleral-contact-lenses
#13
Peng Yan, Mustafa Kapasi, Ronan Conlon, Joshua C Teichman, Season Yeung, Yelin Yang, Setareh Ziai, Kashif Baig
OBJECTIVE: To evaluate short-term visual outcome, patient acceptance, and tolerance of mini-scleral contact lenses (SCLs) in the management of various corneal pathologies. DESIGN: Retrospective case series. PARTICIPANTS: Thirty-two patients (40 eyes) who received mini-SCLs. METHODS: Single-centre retrospective case series, between February 2010 and January 2013, of 32 patients (40 eyes) with various corneal pathologies who were offered either Maxim 5R, Maxim 7, or Maxim 7 × 11 mini-SCLs for nonsurgical optimization of visual correction...
February 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28225492/clinical-application-of-ticl-implantation-for-ametropia-following-deep-anterior-lamellar-keratoplasty-for-keratoconus-a-consort-compliant-article
#14
Qin Qin, Liping Yang, Zifang He, Zhenping Huang
BACKGROUND: This study aimed to investigate the clinical application of phakic toric intraocular collamer lens (TICL) implantation in treating ametropia following deep anterior lamellar keratoplasty (DALK) for patients with keratoconus, especially the effectiveness and safety of high astigmatism and indications of TICL implantation after corneal transplantation. METHODS: Using the self-controlled case series observation approach, 9 patients with ametropia (9 eyes) who underwent DALK surgery for keratoconus 1...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28138772/effect-of-corneal-collagen-crosslinking-on-subsequent-deep-anterior-lamellar-keratoplasty-dalk-in-keratoconus
#15
Friederike Schaub, Philip Enders, Björn O Bachmann, Ludwig M Heindl, Claus Cursiefen
PURPOSE: The purpose was to investigate the impact of ultraviolet light corneal collagen crosslinking (UV-CXL) on the success rate and clinical outcome of subsequent deep anterior lamellar keratoplasty (DALK) in eyes with keratoconus (KC). METHODS: Medical records of 101 consecutive eyes with KC scheduled for big-bubble DALK surgery were screened retrospectively for details of previously performed UV-CXL, as well as intra- and postoperative complications of DALK surgery...
January 30, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28099281/vision-related-quality-of-life-before-and-after-deep-anterior-lamellar-keratoplasty
#16
Elvin Yildiz, Meltem Toklu, Ece Turan Vural
OBJECTIVES: To determine changes in the vision-related quality of life in patients undergoing deep anterior lamellar keratoplasty (DALK) by using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). METHODS: Thirty-five patients who were scheduled for DALK between March 1, 2013, and March 1, 2014 were asked to complete the NEI VFQ-25. NEI VFQ-25 was administered again at 6 months and at 1 year postoperatively. Data on patients' age, sex, preoperative diagnosis, preoperative and postoperative best-corrected visual acuity, and postoperative astigmatism were recorded...
January 17, 2017: Eye & Contact Lens
https://www.readbyqxmd.com/read/28076561/visual-outcomes-after-deep-anterior-lamellar-keratoplasty-using-donor-corneas-without-removal-of-descemet-membrane-and-endothelium
#17
Tatiana Moura Bastos Prazeres, Rodrigo Muller, Tatiana Rayes, Flavio Eduardo Hirai, Luciene Barbosa de Sousa
Purpose: The optical quality of the interface after deep anterior lamellar keratoplasty (DALK) using the big-bubble technique has been shown to be excellent, leading to results comparable to penetrating keratoplasty. However, there is little in the literature with respect to the controversy surrounding the preparation of the donor cornea. The purpose of this study was to evaluate visual acuity (VA) in patients with keratoconus who underwent DALK without removal of the donor graft endothelium...
November 2016: Arquivos Brasileiros de Oftalmologia
https://www.readbyqxmd.com/read/28017678/deep-anterior-lamellar-keratoplasty-after-descemet-stripping-automated-endothelial-keratoplasty
#18
Shay Gutfreund, Pia Leon, Shmuel Graffi, Massimo Busin
PURPOSE: To report the indications and long-term outcomes of deep anterior lamellar keratoplasty (DALK) performed after Descemet stripping automated endothelial keratoplasty (DSAEK) in cases of visually significant stromal opacities. DESIGN: Retrospective, interventional, consecutive case series. METHODS: Setting: Private hospital. STUDY POPULATION: Thirteen eyes that underwent DALK after DSAEK at our institution. Indications for DALK after DSAEK included both stromal opacities persisting after DSAEK and stromal opacities occurring secondarily in post-DSAEK corneas...
March 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28004157/-deep-anterior-lamellar-keratoplasty-experiences-and-results-of-the-first-100-consecutive-dalk-from-the-university-eye-hospital-of-cologne
#19
F Schaub, L M Heindl, P Enders, S Roters, B O Bachmann, C Cursiefen
BACKGROUND: Deep anterior lamellar keratoplasty (DALK) is a treatment option for patients with diseases of the corneal stroma without endothelial involvement and has been used at the Department of Ophthalmology of the University of Cologne since July 2011. Experiences and results of the first 100 consecutive cases from Cologne with a minimum follow-up of 1 year are summarized. MATERIALS AND METHODS: We included the first 100 consecutive DALKs. Indications for anterior lamellar keratoplasty, the feasibility of the surgery, the postoperative course, in addition to the complications and clinical outcome 3 months after complete suture removal, were examined...
December 21, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28002112/wet-peeling-technique-of-deep-anterior-lamellar-keratoplasty-with-hypotonic-water-and-blunt-dissection-for-healed-hydrops
#20
Zelin Zhao, Jinyang Li, Qinxiang Zheng, Wei Lin, Vishal Jhanji, Wei Chen
PURPOSE: To describe the surgical technique and outcomes of "wet-peeling" deep anterior lamellar keratoplasty (DALK) using sterile water and blunt dissection in cases with corneal scarring after healed corneal hydrops. METHODS: Manual DALK using a "wet-peeling" technique was performed in 20 eyes of 20 consecutive patients with healed corneal hydrops between June 2011 and October 2013. RESULTS: Intraoperative microperforations were encountered in 2 (10%) cases...
March 2017: Cornea
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