Redo DALK to Treat High Irregular Astigmatism

Dr. Adeeb Ubeid describes a patient with previous advanced keratoconus who presented after deep anterior lamellar keratoplasty (DALK) with poor uncorrected and corrected vision due to high irregular astigmatism. Repeat DALK was offered to manage this astigmatism, using a meticulous suturing technique to reduce the incidence of postoperative astigmatism. Selective removal of sutures was performed starting 8 months after surgery based on topographic maps. The patient experienced improvement in uncorrected visual acuity, best spectacle-corrected visual acuity, topical maps, and reduction in the amount of astigmatism, which made the patient a good candidate for future refractive procedures. 

Financial Disclosures: Dr. Adeeb Ubeid discloses no financial relationships.