Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus
We compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52)....
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/11/2421 |
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| author | Dominika Janiszewska-Bil Barbara Czarnota-Nowakowska Katarzyna Krysik Anita Lyssek-Boroń Dariusz Dobrowolski Beniamin Oskar Grabarek Edward Wylęgała |
| author_facet | Dominika Janiszewska-Bil Barbara Czarnota-Nowakowska Katarzyna Krysik Anita Lyssek-Boroń Dariusz Dobrowolski Beniamin Oskar Grabarek Edward Wylęgała |
| author_sort | Dominika Janiszewska-Bil |
| collection | DOAJ |
| description | We compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52). This is a prospective, comparative cohort study of 90 eyes (90 patients) with a clinical diagnosis of keratoconus. Patients underwent a complete eye examination before the surgical approach, 6 and 12 months postoperatively that consisted of BCVA, refractive astigmatism (AS), central corneal thickness (CCT), IOP, and ECL. Secondary outcomes were adverse events related to the surgical procedure. With lower ECL and less adverse events, DALK was revealed to be beneficial over PK with similar visual outcomes. Results: There was no significant difference between the BCVA in the DALK and PK groups (at 6 months: 0.49 ± 0.17 vs. 0.48 ± 0.17; <i>p</i> = 0.48; at 12 months: 0.54 ± 0.17 vs. 0.52 ± 0.14; <i>p</i> = 0.41). The mean value of AS was significantly lower after the PK procedure when compared to DALK, after both 6 and 12 months of follow up (<i>p</i> < 0.001). The CCT in the DALK group was significantly lower when compared to the PK group (at 6 months: 452.1 ± 89.1 µm vs. 528.9 ± 69.9 µm, <i>p</i> < 0.0001; at 12 months: 451.6 ± 83.5 µm vs. 525.5 ± 37.1 µm). The endothelial cell loss at 12 months after surgery was significantly lower after DALK when compared to PK (<i>p</i> < 0.0001). DALK transplantation should be considered as an alternative procedure in the surgical treatment of keratoconus. |
| first_indexed | 2024-03-10T10:53:20Z |
| format | Article |
| id | doaj.art-17662a68ab3345ce8428f4234601424e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:53:20Z |
| publishDate | 2021-05-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-17662a68ab3345ce8428f4234601424e2023-11-21T22:03:25ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011011242110.3390/jcm10112421Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with KeratoconusDominika Janiszewska-Bil0Barbara Czarnota-Nowakowska1Katarzyna Krysik2Anita Lyssek-Boroń3Dariusz Dobrowolski4Beniamin Oskar Grabarek5Edward Wylęgała6Optegra Eye Clinic, 40-101 Katowice, PolandOptegra Eye Clinic, 61-101 Poznań, PolandDepartment of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, PolandDepartment of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, PolandDepartment of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, PolandDepartment of Histology, Cytophysiology and Embryology, Faculty of Medicine, University of Technology in Katowice, 41-800 Zabrze, PolandChair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia in Katowice, 40-760 Katowice, PolandWe compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52). This is a prospective, comparative cohort study of 90 eyes (90 patients) with a clinical diagnosis of keratoconus. Patients underwent a complete eye examination before the surgical approach, 6 and 12 months postoperatively that consisted of BCVA, refractive astigmatism (AS), central corneal thickness (CCT), IOP, and ECL. Secondary outcomes were adverse events related to the surgical procedure. With lower ECL and less adverse events, DALK was revealed to be beneficial over PK with similar visual outcomes. Results: There was no significant difference between the BCVA in the DALK and PK groups (at 6 months: 0.49 ± 0.17 vs. 0.48 ± 0.17; <i>p</i> = 0.48; at 12 months: 0.54 ± 0.17 vs. 0.52 ± 0.14; <i>p</i> = 0.41). The mean value of AS was significantly lower after the PK procedure when compared to DALK, after both 6 and 12 months of follow up (<i>p</i> < 0.001). The CCT in the DALK group was significantly lower when compared to the PK group (at 6 months: 452.1 ± 89.1 µm vs. 528.9 ± 69.9 µm, <i>p</i> < 0.0001; at 12 months: 451.6 ± 83.5 µm vs. 525.5 ± 37.1 µm). The endothelial cell loss at 12 months after surgery was significantly lower after DALK when compared to PK (<i>p</i> < 0.0001). DALK transplantation should be considered as an alternative procedure in the surgical treatment of keratoconus.https://www.mdpi.com/2077-0383/10/11/2421keratoconusdeep anterior lamellar keratoplastypenetrative keratoplasty |
| spellingShingle | Dominika Janiszewska-Bil Barbara Czarnota-Nowakowska Katarzyna Krysik Anita Lyssek-Boroń Dariusz Dobrowolski Beniamin Oskar Grabarek Edward Wylęgała Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus Journal of Clinical Medicine keratoconus deep anterior lamellar keratoplasty penetrative keratoplasty |
| title | Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus |
| title_full | Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus |
| title_fullStr | Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus |
| title_full_unstemmed | Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus |
| title_short | Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus |
| title_sort | comparison of long term outcomes of the lamellar and penetrating keratoplasty approaches in patients with keratoconus |
| topic | keratoconus deep anterior lamellar keratoplasty penetrative keratoplasty |
| url | https://www.mdpi.com/2077-0383/10/11/2421 |
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