scholarly journals Visual outcome of penetrating keratoplasty, deep anterior lamellar keratoplasty and Descemet membrane endothelial keratoplasty

2018 ◽  
Vol 11 (3) ◽  
pp. 174-181 ◽  
Author(s):  
Clàudia Garrido ◽  
Genís Cardona ◽  
Josep L. Güell ◽  
Jaume Pujol
Keyword(s):  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty

Descemet Membrane Endothelial Keratoplasty for Failed Deep Anterior Lamellar Keratoplasty

Cornea ◽  
2018 ◽  
Vol 37 (6) ◽  
pp. 682-686 ◽  
Author(s):  
Adi Einan-Lifshitz ◽  
Nir Sorkin ◽  
Tanguy Boutin ◽  
Zale Mednick ◽  
Mohammad Kreimei ◽  
...  
Keyword(s):  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty

Deep anterior lamellar keratoplasty versus penetrating keratoplasty in the treatment of stromal corneal dystrophies

2021 ◽  
Vol 2 (2) ◽  
pp. 116-122
Author(s):  
Ahmed Reda ◽  
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Visual Outcome ◽  
Corneal Dystrophy ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty ◽  
Safety Outcomes

AIM: To compare the efficacy and safety of penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) in the treatment of stromal corneal dystrophy. METHODS: A systematic review and Meta-analysis was conducted for studies comparing visual acuity [best-corrected visual acuity (BCVA) (LogMAR)] and corneal endothelial cell count (ECC) as well as safety outcomes of DALK and PK surgeries, including graft-related outcomes and intraoperative and postoperative complications. Embase, PubMed, and Google Scholar were searched for eligible studies until June 2019. Continuous and dichotomous variables were expressed as weighted mean difference (WMD) and risk ratios (RRs), respectively, along with their respective 95% confidence intervals (CIs). RESULTS: Five comparative studies recruiting 350 patients with macular and/or lattice corneal dystrophy (59.71% males) were eventually included. No significant differences were noted in the mean BCVA after both types of surgeries. However, following DALK procedures, corneal ECC was significantly higher two years postoperatively (WMD=401.62 cell/mm2, 95%CI: 285.39-517.85, P<0.001), and graft and endothelial rejection rates were significantly lower (RR=0.30, 95%CI: 0.14-0.64, P=0.002; RR=0.09, 95%CI: 0.02-0.46, P=0.004, respectively) when compared to patients undergoing PK procedures. However, DALK procedures were associated with increased risks of intraoperative Descemet’s membrane perforations and postoperative double anterior chamber (All P<0.001). CONCLUSION: DALK procedures are relatively more efficacious over the follow up periods with better safety outcomes than PK in patients with stromal CDs, conerning rejection and better visual outcome.

Corneal transplantation trends in France from 2004 to 2015: A 12-year review

2018 ◽  
Vol 28 (5) ◽  
pp. 535-540 ◽  
Author(s):  
Guillaume Bigan ◽  
Marc Puyraveau ◽  
Maher Saleh ◽  
Philippe Gain ◽  
Isabelle Martinache ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Dystrophy ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Surgical Indications ◽  
Anterior Lamellar Keratoplasty ◽  
Important Shift

Purpose: The aim of this study was to report the 12-year longitudinal trends in indication and corneal transplantation techniques in France from 2004 to 2015. Results: The records of all corneal transplantations performed from 2004 to 2015 in France were retrospectively reviewed. The patient indications and types of transplant performed were analyzed. A total of 46,658 corneal transplantations were performed between 2004 and 2015, with 34,187 (73.3%) penetrating keratoplasty and 10,452 (22.4%) lamellar keratoplasty. The leading surgical indications were secondary endothelial failure (24.3%), keratoconus (18.8%), regraft (13.5%), and Fuchs endothelial corneal dystrophy (15.1%). Endothelial keratoplasty became the preferred technique for endothelial diseases and deep anterior lamellar keratoplasty the preferred technique for keratoconus, surpassing penetrating keratoplasty in 2013. Conclusion: Secondary endothelial failure is the top indication for performing a keratoplasty over the 12-year period. There was a shift from penetrating keratoplasty to endothelial keratoplasty performed for Fuchs endothelial corneal dystrophy and secondary endothelial failure, and to deep anterior lamellar keratoplasty, performed for keratoconus. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.

scholarly journals A Simple Technique for Descemet Membrane Exposure in Deep Anterior Lamellar Keratoplasty Using the Transconjunctival Single-plane Sclerocorneal Incision

2021 ◽  
Author(s):  
Takahiko Hayashi ◽  
Satoru Yamagami
Keyword(s):  
Penetrating Keratoplasty ◽  
Simple Technique ◽  
Case Series ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Single Plane ◽  
Descemet Membrane ◽  
Anterior Lamellar Keratoplasty ◽  
Membrane Exposure ◽  
Big Bubble

Abstract Background: To describe a simple technique for Descemet membrane exposure during deep anterior lamellar keratoplasty (DALK).Methods: As a prospective interventional case series, consecutive patients who underwent DALK were enrolled. The technique involved the separation of the Descemet membrane by injecting air and ophthalmic viscosurgical devices from the point where transconjunctival single-plane sclerocorneal incision with the slit knife is terminated prior to perforation using a mirror image. Descemet membrane exposure success rates and the incidence of intra- and postoperative complications were analyzed. Outcomes of successful DALK procedures, which were not converted to penetrating keratoplasty, were analyzed by evaluating best corrected visual acuity (BCVA; converted to logarithm of the minimum angle of resolution [logMAR]) and graft survival.Results: We included 11 eyes from 11 patients (seven males and four females; 53.6 ± 16.1 years; mean follow-up duration, 26.1 weeks [6–51 weeks]). Ten surgeries were successful in Descemet membrane exposure without rupture, eight were successful in big-bubble formation, and two were finally successful in Descemet membrane exposure after a failed big-bubble. The DALK procedure for only one eye was converted to a penetrating keratoplasty owing to a tear in the Descemet membrane. BCVA improved from 0.83 ± 0.38 logMAR preoperatively to 0.24 ± 0.12 logMAR postoperatively (n=10, p < 0.001). There was no primary graft failure.Conclusion: This simple technique of transconjunctival single-plane sclerocorneal incision could be very useful for exposing the Descemet membrane during DALK.

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