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Outcomes of deep anterior lamellar keratoplasty and penetrating keratoplasty in keratoconic eyes with and without previous hydrops

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Abstract

Purpose

The study aims to compare outcomes after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in keratoconic eyes with or without previous hydrops.

Methods

Retrospective analysis of 211 eyes who received PK (group 1, n = 74 [history of hydrops: n = 33]) or DALK (group 2, n = 137 [history of hydrops: n = 9]) from 2012 to 2019 at the Department of Ophthalmology, University of Cologne, Germany. Analysis included best spectacle-corrected visual acuity (BSCVA), complications, immune reactions, graft survival and keratometry, and subgroup analyses for subjects with or without previous hydrops.

Results

Follow-up was 34.0 ± 23.6 months in group 1 and 30.7 ± 22.5 months in group 2. No significant difference was found in the course of BSCVA between groups 1 and 2 (p = 0.182) and in postoperative BSCVA between eyes with and without previous hydrops, regardless of the surgical method (p = 0.768). Endothelial immune reactions occurred exclusively in group 1 and did not occur more frequently in eyes with previous hydrops (p = 0.377). A higher risk of complications for eyes with previous hydrops was observed (p = 0.022). There was no difference in astigmatism and maximum keratometry (Kmax) preoperatively and postoperatively between eyes with and without history of hydrops.

Conclusion

The prognosis for visual outcome after keratoplasty including visual acuity, astigmatism, and Kmax for keratoconic eyes with previous hydrops is as good as for keratoconic eyes without previous hydrops, irrespective of the surgical method. However, eyes after hydrops seem to have an increased risk of complications.

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Data availability

From the patient data of the Department of Ophthalmology, University of Cologne.

Code availability

Not applicable.

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Funding

German Research Foundation (DFG) FOR2240 “(Lymph)angiogenesis and Cellular Immunity in Inflammatory Diseases of the Eye” (www.for2240.de); EU Horizon 2020 ARREST BLINDNESS (CC; www.arrestblindness.eu); EU COST CA18116 (CC; www.aniridia-net.eu); and Center for Molecular Medicine Cologne, University of Cologne (CC, DH; www.cmmc-uni-koeln.de) provided financial support.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany

    Alexander Händel, Jan Niklas Lüke, Sebastian Siebelmann, Sigrid Roters, Mario Matthaei, Björn O. Bachmann, Claus Cursiefen & Deniz Hos

  2. Institute of Medical Statistics and Bioinformatics, Cologne, Germany

    Jeremy Franklin

  3. Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50937, Cologne, Germany

    Claus Cursiefen & Deniz Hos

Authors
  1. Alexander Händel
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  2. Jan Niklas Lüke
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  3. Sebastian Siebelmann
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  4. Jeremy Franklin
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  5. Sigrid Roters
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  6. Mario Matthaei
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  7. Björn O. Bachmann
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  8. Claus Cursiefen
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  9. Deniz Hos
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Alexander Händel, Jan Niklas Lüke, Sebastian Siebelmann, Deniz Hos, and Jeremy Franklin. The first draft of the manuscript was written by Alexander Händel and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alexander Händel.

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Ethics Committee of the University of Cologne ruled that approval was not required for this study.

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Händel, A., Lüke, J.N., Siebelmann, S. et al. Outcomes of deep anterior lamellar keratoplasty and penetrating keratoplasty in keratoconic eyes with and without previous hydrops. Graefes Arch Clin Exp Ophthalmol 260, 2913–2923 (2022). https://doi.org/10.1007/s00417-022-05643-4

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  • DOI: https://doi.org/10.1007/s00417-022-05643-4

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