Abstract
Purpose: To compare postoperative astigmatism and visual outcome in patients operated for penetrating keratoplasty and deep lamellar keratoplasty.
Method: his study was conducted at Ophthalmology Department of our hospital during July 2011- November 2013. Patients who clinically presented with a corneal opacity, Corneal stromal dystrophies , Corneal stromal degenerations, Deep corneal scarring (post traumatic, post infection, & other stromal scar.) who had a best corrected visual acuity BCVA of less than 6|60(=1.0 in log MAR) and not improving beyond it during july 2011- November 2013in our institute were chosen. DALK was done in 17 eyes and sixth month post operatively for1.Uncorrected visual acuity. 2. Best corrected visual acuity 3. Slit lamp examination. 4. Tonometry. 5. Corneal topography.
Result: The difference between BCVA at 6 month between two groups DALK and PKP. After applying independent t-test there is t –value of 0.776 with ‘p’ value of 0.452, which is >0.05. so there is no significant difference between BCVA at 6 month between DALK and PKP group.
Conclusion: After Both procedures there is significant improvement in post-operative visual acuity (measured in logarithm of Minimum Angle of Resolution) at each follow up when compared with pre-operative visual acuity. Both procedures having problem of post-operative Astigmatism.
References
- Shimmura S, Tsubota K. Deep anterior lamellar keratoplasty. Curr Opin Ophthalmol 2006; 17:349 –55.
- Kawashima M, Kawakita T, Den S, et al. Comparison of deep lamellar keratoplasty and penetrating keratoplasty for lattice and macular corneal dystrophies. Am J Ophthalmol 2006;142: 304–9
- Krumeich JH, Knulle A, Krumeich BM. Deep anterior lamellar (DALK) vs. penetrating keratoplasty (PKP): a clinical and statistical analysis [in German]. Klin Monbl Augenheilkd 2008;225:637– 48.
- Anwar M, Teichmann KD. Big-bubble technique to bare Descemet’s membrane in anterior lamellar keratoplasty. J Cataract Refract Surg 2002;28:398–403
- Senoo T, Chiba K, Terada O, et al. Deep lamellar keratoplasty by deep parenchyma detachment from the corneal limbs. Br J Ophthalmol 2005;89:1597– 600.
- Shimmura S, Shimazaki J, Omoto M, et al. Deep lamellar keratoplasty (DLKP) in keratoconus patients using viscoadaptive viscoelastics. Cornea 2005;24:178–81.
- Farid M, Steinert RF. Deep anterior lamellar keratoplasty performed with the femtosecond laser zigzag incision for the treatment of stromal corneal pathology and ectatic disease. J Cataract Refract Surg 2009;35:809 –13.
- Price FW Jr, Price MO, Grandin JC, Kwon R. Deep anterior lamellar keratoplasty with femtosecond-laser zigzag incisions. J Cataract Refract Surg 2009;35:804–8.
- 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.
- Manche EE, Holland GN, Maloney RK. Deep lamellar keratoplasty using viscoelastic dissection. Arch Ophthalmol 1999; 117:1561–5.
- Tsubota K, Kaido M, Monden Y, et al. A new surgical technique for deep lamellar keratoplasty with single running suture adjustment. Am J Ophthalmol 1998;126:1– 8.
- Melles GR, Lander F, Rietveld FJ, et al. A new surgical technique for deep stromal, anterior lamellar keratoplasty. Br J Ophthalmol 1999;83:327–33.
- Yoo SH, Kymionis GD, Koreishi A, et al. Femtosecond laserassisted sutureless anterior lamellar keratoplasty. Ophthalmology 2008;115:1303–7.
Corresponding Author
Dr Tejal Paneria
MBBS MS (Ophthal), SMIMER Hospital, Surat
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.63
