Deep anterior lamellar keratoplasty: Is a bare descemet necessary?

Abstract

Objective: Evaluate the anatomical, refractive, and functional results of an innovative technique of deep anterior lamellar keratoplasty with a manual spatula and discuss if a bare Descemet is really necessary in DALK. Materials and Methods: We evaluated the results and examinations of 16 eyes frompatients who underwent deep anterior lamellar keratoplasty using the technique described by Ferrara. Residual bed thickness after keratoplasty was evaluatedpostoperatively using Visante. The measurement was performed using a technique similar to that used to measure flap thickness after laser in situ keratomileusis refractive surgery. The measurements were performed at the center of the cornea in an area comprising the central 3-mm in the 45° and 135° meridians. Results: Best-corrected visual acuity was 0.34 ± 0.18 LogMar (0.09 to 0.60 LogMar), the spherical equivalent was -4.31 ± 3.38 D (+0.25 to -9.50 diopters), and keratometry was 45.75 ± 2.77 D (41.11 to 52.48 diopters) postoperatively. Corneal astigmatism was 3.19 ± 2.78 D (0.18 to 11.81 diopters). Residual stromal bed thickness measured by optical coherence tomography showed values of 67.1 ± 24.3 μm (30 to 109 μm). Conclusion: Deep anterior lamellar keratoplasty, in which manual dissection was performed using an instrument similar to that used to implant corneal rings, provided good visual and anatomical results. © 2015 by Nova Science Publishers, Inc. All rights reserved.