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Deep Anterior Lamellar Keratoplasty

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https://www.readbyqxmd.com/read/28505034/pediatric-corneal-transplants
#1
Danielle Trief, Maria C Marquezan, Christopher J Rapuano, Christina R Prescott
PURPOSE OF REVIEW: Pediatric keratoplasty poses unique challenges in clinical and surgical management. However, successful transplantation can afford a child vision in an otherwise poorly seeing eye. This review will provide an update on recent advances in pediatric keratoplasty. RECENT FINDINGS: Although children who receive corneal transplants remain at increased risk of rejection, infection, and graft dehiscence compared with adult corneal transplant recipients, new surgical techniques, and advances in clinical management have led to better outcomes...
May 12, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28503733/long-term-safety-from-transmission-of-porcine-endogenous-retrovirus-after-pig-to-non-human-primate-corneal-transplantation
#2
Hyuk Jin Choi, Jiyeon Kim, Jae Young Kim, Hyun Ju Lee, Won Ryang Wee, Mee Kum Kim, Eung Soo Hwang
BACKGROUND: The risk of xenozoonosis mainly by porcine endogenous retrovirus (PERV) has been considered as one of the main hurdles in xenotransplantation and therefore should be elucidated prior to the clinical use of porcine corneal grafts. Accordingly, an investigation was performed to analyze the infectivity of PERVs from porcine keratocytes to human cells, and the long-term risk of transmission of PERVs was determined using pig-to-non-human primate (NHP) corneal transplantation models...
May 14, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28481010/dynamics-of-big-bubble-formation-in-deep-anterior-lamellar-keratoplasty-by-the-big-bubble-technique-in%C3%A2-vitro-studies
#3
Harminder S Dua, Lana A Faraj, Mohamed B Kenawy, Saief AlTaan, Mohamed S Elalfy, Tarek Katamish, Dalia G Said
PURPOSE: To examine the movement of air injected in the cornea in simulated deep anterior lamellar keratoplasty (DALK), from the needle tip to the formation of different types of big bubbles (BB) and to ascertain how air travels through the stroma and pre-Descemet's layer [Dua's layer (PDL)] to create a type-1 (air between PDL and deep stroma) and type-2BB (air between PDL and Descemet's membrane). METHODS: Air was injected in 57 sclerocorneal discs and the passage recorded...
May 8, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28458708/femtosecond-laser-arcuate-keratotomy-for-the-correction-of-postkeratoplasty-high-astigmatism-in-keratoconus
#4
Mohammad Naser Hashemian, Habib Ojaghi, Mehrdad Mohammadpour, Mahmoud Jabbarvand, Firouzeh Rahimi, Mohammad-Ali Abtahi, Mehdi Mazloumi, Seyed-Hossein Abtahi
BACKGROUND: Astigmatism is the leading complication in visual recovery after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK); in this study, we evaluated the outcome of femtosecond laser arcuate keratotomy (FLAK) after DALK and PKP in Iranian keratoconic patients. MATERIALS AND METHODS: In this prospective interventional case series, refractive and keratometric predictability, efficacy, and complications of FLAK for postkeratoplasty astigmatism in keratoconus were evaluated; 23 eyes of 23 consecutive patients (mean age of 32...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28457284/corneal-surgery-in-the-flying-eye-hospital-characteristics-and-visual-outcome
#5
Javed Hussain Farooqui, Emile Sharifi, Ahmed Gomaa
OBJECTIVE: The Flying Eye Hospital (FEH) of ORBIS International is a capacity-building platform that trains ophthalmologists throughout the developing world on-board a fully functional eye hospital based in an airplane and in the local hospitals of developing countries. Corneal blindness (CB) is the second leading cause of blindness in most developing countries. Treatment of existing global CB requires effective eye banking and surgeons trained in corneal transplant. ORBIS International has programs that addressed both those needs...
April 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28455642/double-bubble-with-the-big-bubble-technique-during-deep-anterior-lamellar-keratoplasty
#6
Stephanie Wise, Paul Dubord, Sonia N Yeung
PURPOSE: To report a case of intraoperative double bubble that formed during big-bubble DALK surgery in a patient with corneal scarring secondary to herpetic stromal keratitis. METHODS: Case report. RESULTS: A 22 year old woman presented with a large corneal scar, likely secondary to previous herpetic stromal keratitis. She underwent big-bubble DALK surgery for visual rehabilitation. Intraoperatively, a mixed bubble with persistent type 2 bubble postoperatively was noted...
April 28, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28440250/outcomes-of-deep-anterior-lamellar-keratoplasty-following-autologous-simple-limbal-epithelial-transplant-in-pediatric-unilateral-severe-chemical-injury
#7
Divya Singh, M Vanathi, Chanchal Gupta, Noopur Gupta, Radhika Tandon
AIMS: To evaluate outcomes of deep anterior lamellar keratoplasty (DALK) in pediatric eyes with unilateral severe chemical injury which have undergone autologous simple limbal epithelial transplant (SLET). SETTINGS AND DESIGN: The study design was a retrospective case series. MATERIALS AND METHODS: This retrospective, case series of all children <16 years of age that have undergone DALK following autologous SLET procedure in unilateral severe chemical injury evaluates the outcomes and complications in the setting of a tertiary care center in North India...
March 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28405478/comparison-of-outcomes-in-patients-who-underwent-deep-anterior-lamellar-keratoplasty-and-those-converted-to-penetrating-keratoplasty
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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