Skip to main content

Advertisement

SpringerLink
Log in

Comparing deep anterior lamellar keratoplasty and automated lamellar therapeutic keratoplasty in patients with keratoconus

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

We compared outcomes of deep anterior lamellar keratoplasty (DALK) and automated lamellar therapeutic keratoplasty (ALTK) in patients with keratoconus.

Methods

Seventy eyes with keratoconus that underwent corneal transplantation using either DALK (n = 40) or ALTK (n = 30) were included in this retrospective study. DALK was performed with Anwar’s big-bubble technique and ALTK using an ALTK system. Best-corrected visual acuity (BCVA), refractive results, and complications were analyzed.

Results

Mean follow-up in the DALK (16.68 ± 3.36 months) and ALTK (15.27 ± 2.50 months) groups were similar (p = 0.058). Mean final BCVA of patients in the DALK group was 0.31 ± 0.14 logarithm of the minimum angle of resolution (logMAR) and in the ALTK group 0.34 ± 0.15 logMAR, (p = 0.492). Corresponding figures for final postoperative spherical equivalents were −3.45 ± 0.77 D and −4.19 ± 0.99 D, respectively (p = 0.001). Final postoperative degree of astigmatism was similar in the two groups: DALK −4.28 ± 0.66 D; ALTK −4.50 ± 1.05 D (p = 0.307).

Conclusion

Final visual acuity outcomes were comparable for the DALK and ALTK groups. Thus, ALTK seem to be as efficacious as DALK for surgical treatment of keratoconus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Krachmer JH, Feder RS, Belin MW. Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol. 1984;28:293–322.

    Article  CAS  PubMed  Google Scholar 

  2. Vail A, Gore SM, Bradley BA, Easty DL, Rogers CA. Corneal graft survival and visual outcome. A multicenter Study. Corneal transplant follow-up study collaborators. Ophthalmology. 1994;101:120–7.

    Article  CAS  PubMed  Google Scholar 

  3. Malbran E. Lamellar keratoplasty in keratoconus. In: King JH, McTigue JW, editors. The Cornea-World Congress, vol 511. Washington DC: Butterworths; 1956.

  4. Paufique L. Therapeutic lamellar corneal transplantation. Bull Mem Soc Franc Ophthal. 1949;62:210.

    Google Scholar 

  5. Tan DT, Por YM. Current treatment options for corneal ectasia. Curr Opin Ophthalmol. 2007;18:284–9.

    Article  PubMed  Google Scholar 

  6. Melles GR, Lander F, Rietveld FJ, Remeijer L, Beekhuis WH, Binder PS. A new surgical technique for deep stromal, anterior lamellar keratoplasty. Br J Ophthalmol. 1999;83:327–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Anwar M, Teichmann KD. Big-bubble technique to bare Descemet’s membrane in anterior lamellar keratoplasty. J Cataract Refract Surg. 2002;28:398–403.

    Article  PubMed  Google Scholar 

  8. Anwar M, Teichmann KD. Deep lamellar keratoplasty: surgical techniques for anterior lamellar keratoplasty with and without baring of Descemet’s membrane. Cornea. 2002;21:374–83.

    Article  PubMed  Google Scholar 

  9. Lim L, Pesudovs K, Coster DJ. Penetrating keratoplasty for keratoconus: visual outcome and success. Ophthalmology. 2000;107:1125–31.

    Article  CAS  PubMed  Google Scholar 

  10. Amayem AF, Anwar M. Fluid lamellar keratoplasty in keratoconus. Ophthalmology. 2000;107:76–9. (discussion 80).

    Article  CAS  PubMed  Google Scholar 

  11. Coombes AG, Kirwan JF, Rostron CK. Deep lamellar keratoplasty with lyophilised tissue in the management of keratoconus. Br J Ophthalmol. 2001;85:788–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Watson SL, Ramsay A, Dart JK, Bunce C, Craig E. Comparison of deep lamellar keratoplasty and penetrating keratoplasty in patients with keratoconus. Ophthalmology. 2004;111:1676–82.

    Article  PubMed  Google Scholar 

  13. Bahar I, Kaiserman I, Srinivasan S, Ya-Ping J, Slomovic AR, Rootman DS. Comparison of three different techniques of corneal transplantation for keratoconus. Am J Ophthalmol. 2008;146:905–12, e901.

    Article  PubMed  Google Scholar 

  14. Cohen AW, Goins KM, Sutphin JE, Wandling GR, Wagoner MD. Penetrating keratoplasty versus deep anterior lamellar keratoplasty for the treatment of keratoconus. Int Ophthalmol. 2010;30:675–81.

    Article  PubMed  Google Scholar 

  15. Ansari EA, Morrell AJ, Sahni K. Corneal perforation and decompensation after automated lamellar keratoplasty for hyperopia. J Cataract Refract Surg. 1997;23:134–6.

    Article  CAS  PubMed  Google Scholar 

  16. Li L, Behrens A, Sweet PM, Osann KE, Chuck RS. Corneal lenticule harvest using a microkeratome and an artificial anterior chamber system at high intrachamber pressure. J Cataract Refract Surg. 2002;28:860–5.

    Article  PubMed  Google Scholar 

  17. Bourne WM, Hodge DO, Nelson LR. Corneal endothelium five years after transplantation. Am J Ophthalmol. 1994;118:185–96.

    Article  CAS  PubMed  Google Scholar 

  18. Sharma N, Gupta V, Vanathi M, Agarwal T, Vajpayee RB, et al. Microbial keratitis following lamellar keratoplasty. Cornea. 2004;23:472–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey

    Banu Torun Acar, I. Bülent Buttanri, M. Şahin Sevim & Suphi Acar

  2. Department of Ophthalmology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey

    O. Sevki Arslan

  3. Tıbbiye cad. Haydarpasa Numune Hastanesi, Goz Hastalıkları Klinigi, 34688, Uskudar, Istanbul, Turkey

    Banu Torun Acar

Authors
  1. Banu Torun Acar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. Sevki Arslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. Bülent Buttanri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Şahin Sevim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Suphi Acar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Banu Torun Acar.

About this article

Cite this article

Acar, B.T., Arslan, O.S., Buttanri, I.B. et al. Comparing deep anterior lamellar keratoplasty and automated lamellar therapeutic keratoplasty in patients with keratoconus. Jpn J Ophthalmol 55, 327–332 (2011). https://doi.org/10.1007/s10384-011-0044-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-011-0044-0

Keywords

Search

Navigation