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A retrospective study comparing DALK and PKP in the treatment of necrotizing stromal keratitis

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Abstract

Purpose

To compare the clinical outcomes of deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PKP) in the treatment of necrotizing stromal keratitis (NSK).

Methods

A retrospective study of NSK patients who underwent keratoplasty between January 2015 and December 2017 in the Third Xiangya Hospital was carried out. Data including preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, graft survival rates, corneal endothelial cell density, corneal topography and thickness were reviewed and analyzed by SPSS 23.0 software.

Results

Fifty patients were involved. Twenty-five patients received DALK, and the other half received PKP. The average follow-up period was 10.28 ± 5.92 months. At the end of the follow-up period, there were no significant differences in postoperative BCVA, recurrence of virus, graft rejection or graft failure between the two groups. There were also no significant differences in average central corneal thickness postoperatively at 3 months. However, the average corneal endothelial cell density at 3 months was significantly higher in the DALK group (2121.12 ± 450.80 cell/mm2 in the DALK group versus 1812.16 ± 340.38 cell/mm2 in the PKP group, P = 0.009).

Conclusion

Both DALK and PKP could increase visual acuity and prevent the progression of NSK. There were no significant differences between DALK and PKP in postoperative BCVA, rate of rejection, graft failure or recurrence rate. DALK significantly reduced the loss of corneal endothelial cells.

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Funding

This study was funded by Research grants from “Science and technology support plan of Hunan Province,” Grant Number: 2015DK3007.

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Author notes

  1. Hanhan Liu and Shuirong Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Changsha, 410013, Hunan, China

    Hanhan Liu, Shuirong Liu, Hui Tao, Shuyu Hu & Zhihong Deng

  2. Department of Ophthalmology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, 410005, Hunan, China

    Jia Tan

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  1. Hanhan Liu
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  2. Shuirong Liu
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  3. Hui Tao
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  4. Shuyu Hu
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  6. Jia Tan
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Correspondence to Zhihong Deng or Jia Tan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Liu, H., Liu, S., Tao, H. et al. A retrospective study comparing DALK and PKP in the treatment of necrotizing stromal keratitis. Int Ophthalmol 40, 1713–1721 (2020). https://doi.org/10.1007/s10792-020-01339-y

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  • DOI: https://doi.org/10.1007/s10792-020-01339-y

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