MAR 26, 2013
This prospective study found that big-bubble deep anterior lamellar keratoplasty (DALK) is a viable option in subjects with post-keratitis and post-traumatic corneal scars and normal Descemet's membrane and endothelium.
Thirty-six patients with corneal stromal scarring secondary to healed infectious keratitis or trauma were recruited at a corneal clinic in India.
A big bubble was achieved in all eyes. Mean BCVA improved significantly, with nearly half of the patients achieving a final BCVA of ≥ 0.5 six months postoperatively.
Intraoperative perforation of Descemet's membrane occurred in six eyes and two eyes required penetrating keratoplasty (PK).
A double anterior chamber occurred during the immediate postoperative period in three cases. Raised IOP was seen in one eye. Corneal stromal graft rejection was noted in two cases (5.5 percent) during the first three months after surgery. Graft failure occurred in two cases (5.5 percent).
The authors say this study highlights the successful use of big-bubble DALK to treat cases with corneal scarring attributable to infectious keratitis and nonperforating trauma. They note that an unsuccessful DALK procedure in the cases in this series would not have precluded or increased the risk of failure of a subsequent PK.