Complications and Management of Deep Anterior Lamellar Keratoplasty
Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK) surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s b...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Yayinevi
2014-10-01
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| Series: | Türk Oftalmoloji Dergisi |
| Subjects: | |
| Online Access: | http://www.oftalmoloji.org/article_7370/Complications-And-Management-Of-Deep-Anterior-Lamellar-Keratoplasty |
| Summary: | Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar
keratoplasty (DALK) surgery.
Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK
using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative
and postoperative complications as well as the management and treatment of these complications were evaluated.
Results: Big bubble was created in 220 (77.5%) eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5%) eyes.
Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK). Intraoperative
microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air
injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC) occurred in 32 of 40 eyes. DAC
spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved
in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period,
this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed.
Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific
complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40) |
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| ISSN: | 1300-0659 2147-2661 |