Deep anterior lamellar keratoplasty in eyes previously treated with collagen crosslinking for keratoconus: 3-year results

Purpose To evaluate the 3-year results of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in keratoconus patients with previous corneal collagen crosslinking (CXL) treatment. Methods Twenty eyes of 20 keratoconus patients who underwent DALK surgery using the big-bubble tech...

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Bibliographic Details
Published in:Graefe's archive for clinical and experimental ophthalmology 2020-04, Vol.258 (4), p.821-827
Main Authors: Kubaloglu, Anıl, Sari, Esin Sogutlu, Koytak, Arif
Format: Article
Language:English
Subjects:
Acuity
Adolescent
Adult
Astigmatism
Cell density
Collagen
Collagen - pharmacology
Cornea
Cornea - drug effects
Cornea - pathology
Cornea - surgery
Corneal Topography - methods
Corneal transplantation
Cross-Linking Reagents - pharmacology
Endothelial cells
Eye
Eye surgery
Female
Follow-Up Studies
Humans
Keratoconus
Keratoconus - diagnosis
Keratoconus - therapy
Keratoplasty, Penetrating - methods
Male
Medicine
Medicine & Public Health
Ophthalmology
Patients
Photochemotherapy - methods
Refraction, Ocular
Retrospective Studies
Surgery
Surgical outcomes
Time Factors
Visual Acuity
Young Adult
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Summary:Purpose To evaluate the 3-year results of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in keratoconus patients with previous corneal collagen crosslinking (CXL) treatment. Methods Twenty eyes of 20 keratoconus patients who underwent DALK surgery using the big-bubble technique after CXL treatment between January 2011 and September 2015 were retrospectively reviewed. All patients completed 3 years follow-up. Intraoperative and postoperative complications were recorded. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), maximum keratometry, keratometric astigmatism and endothelial cell density (ECD) were analysed. Results The mean interval between CXL and DALK surgery was 47.5 ± 24.0 months (mean ± SD). DALK was completed in all eyes. Big-bubble was successfully achieved in 16 eyes (80%), and manual dissection was performed in four eyes (20%). Microperforation occurred in three eyes (15%). Postoperatively, persistent epithelial defect occurred in three eyes (15%). The mean UCVA and mean BSCVA values were significantly improved preoperatively to all postoperative visits ( p  
ISSN:0721-832X
1435-702X
DOI:10.1007/s00417-019-04587-6