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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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| Published in: | Graefe's archive for clinical and experimental ophthalmology 2020-04, Vol.258 (4), p.821-827 |
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| creator | Kubaloglu, Anıl Sari, Esin Sogutlu Koytak, Arif |
| description | 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
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| doi_str_mv | 10.1007/s00417-019-04587-6 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2335168792</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2377013022</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-add671e3d84865ec15353cbf016a9dce70fdc6e4a44c9415a7af435fc949dd913</originalsourceid><addsrcrecordid>eNp9kc1O3DAUhS3UihkGXqCLylI33bjYcRwn7BAUWmmkblqJneWxb6aBjB1shypvj-eHIrFgZV35O-f6-CD0idFvjFJ5HiktmSSUNYSWopakOkJzVnJBJC3uPqA5lQUjNS_uZugkxnuaeS7YMZpx1jDRyGKOpmuAAWuXIHQ-4F5voO91wA8QdPJDr2OacOcwTBDxEOCp82PsJ5wC6AQW_-vSX2x81qzBYRN8jH3nHjq3xq1_sTHejfECczJBtg4Qxz7FU_Sx1X2Es8O5QH9uvv---kGWv25_Xl0uieFSJKKtrSQDbuuyrgQYJrjgZtVSVunGGpC0taaCUpelaUomtNRtTtnmobG2YXyBvu59h-AfR4hJbbpotikd5Cyq4PlPqlo2RUa_vEHv_Rhcfl2mpKSM02JLFXtqlzZAq4bQbXSYFKNqW4zaF6NyMWpXjKqy6PPBelxtwP6XvDSRAb4HYr5yawivu9-xfQaqj5uP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2377013022</pqid></control><display><type>article</type><title>Deep anterior lamellar keratoplasty in eyes previously treated with collagen crosslinking for keratoconus: 3-year results</title><source>Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List</source><creator>Kubaloglu, Anıl ; Sari, Esin Sogutlu ; Koytak, Arif</creator><creatorcontrib>Kubaloglu, Anıl ; Sari, Esin Sogutlu ; Koytak, Arif</creatorcontrib><description>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
< 0.001). UCVA was 20/100 or lower in all eyes preoperatively and 20/100 or better in 18 eyes (80%) at 3 years; BSCVA was 20/40 or better in all eyes (100%) and 20/20 or better in three eyes (15%), and keratometric astigmatism was lower than 4 dioptres in 14 eyes (70%) at 3 years. The mean ECD loss was 6.3 ± 4.4% at 1 year, 9.0 ± 6.3% at 2 years and 11.2 ± 7.4% at 3 years.
Conclusion
Previous CXL treatment in keratoconus patients did not cause a negative impact on the visual, refractive and surgical outcomes of DALK surgery using the big-bubble technique. DALK surgery seems to be a safe and effective surgical approach in these patients.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-019-04587-6</identifier><identifier>PMID: 31915972</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>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</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2020-04, Vol.258 (4), p.821-827</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Graefe's Archive for Clinical and Experimental Ophthalmology is a copyright of Springer, (2020). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-add671e3d84865ec15353cbf016a9dce70fdc6e4a44c9415a7af435fc949dd913</citedby><cites>FETCH-LOGICAL-c375t-add671e3d84865ec15353cbf016a9dce70fdc6e4a44c9415a7af435fc949dd913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31915972$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kubaloglu, Anıl</creatorcontrib><creatorcontrib>Sari, Esin Sogutlu</creatorcontrib><creatorcontrib>Koytak, Arif</creatorcontrib><title>Deep anterior lamellar keratoplasty in eyes previously treated with collagen crosslinking for keratoconus: 3-year results</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>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
< 0.001). UCVA was 20/100 or lower in all eyes preoperatively and 20/100 or better in 18 eyes (80%) at 3 years; BSCVA was 20/40 or better in all eyes (100%) and 20/20 or better in three eyes (15%), and keratometric astigmatism was lower than 4 dioptres in 14 eyes (70%) at 3 years. The mean ECD loss was 6.3 ± 4.4% at 1 year, 9.0 ± 6.3% at 2 years and 11.2 ± 7.4% at 3 years.
Conclusion
Previous CXL treatment in keratoconus patients did not cause a negative impact on the visual, refractive and surgical outcomes of DALK surgery using the big-bubble technique. DALK surgery seems to be a safe and effective surgical approach in these patients.</description><subject>Acuity</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Astigmatism</subject><subject>Cell density</subject><subject>Collagen</subject><subject>Collagen - pharmacology</subject><subject>Cornea</subject><subject>Cornea - drug effects</subject><subject>Cornea - pathology</subject><subject>Cornea - surgery</subject><subject>Corneal Topography - methods</subject><subject>Corneal transplantation</subject><subject>Cross-Linking Reagents - pharmacology</subject><subject>Endothelial cells</subject><subject>Eye</subject><subject>Eye surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Keratoconus</subject><subject>Keratoconus - diagnosis</subject><subject>Keratoconus - therapy</subject><subject>Keratoplasty, Penetrating - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Ophthalmology</subject><subject>Patients</subject><subject>Photochemotherapy - methods</subject><subject>Refraction, Ocular</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Time Factors</subject><subject>Visual Acuity</subject><subject>Young Adult</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kc1O3DAUhS3UihkGXqCLylI33bjYcRwn7BAUWmmkblqJneWxb6aBjB1shypvj-eHIrFgZV35O-f6-CD0idFvjFJ5HiktmSSUNYSWopakOkJzVnJBJC3uPqA5lQUjNS_uZugkxnuaeS7YMZpx1jDRyGKOpmuAAWuXIHQ-4F5voO91wA8QdPJDr2OacOcwTBDxEOCp82PsJ5wC6AQW_-vSX2x81qzBYRN8jH3nHjq3xq1_sTHejfECczJBtg4Qxz7FU_Sx1X2Es8O5QH9uvv---kGWv25_Xl0uieFSJKKtrSQDbuuyrgQYJrjgZtVSVunGGpC0taaCUpelaUomtNRtTtnmobG2YXyBvu59h-AfR4hJbbpotikd5Cyq4PlPqlo2RUa_vEHv_Rhcfl2mpKSM02JLFXtqlzZAq4bQbXSYFKNqW4zaF6NyMWpXjKqy6PPBelxtwP6XvDSRAb4HYr5yawivu9-xfQaqj5uP</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Kubaloglu, Anıl</creator><creator>Sari, Esin Sogutlu</creator><creator>Koytak, Arif</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20200401</creationdate><title>Deep anterior lamellar keratoplasty in eyes previously treated with collagen crosslinking for keratoconus: 3-year results</title><author>Kubaloglu, Anıl ; Sari, Esin Sogutlu ; Koytak, Arif</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-add671e3d84865ec15353cbf016a9dce70fdc6e4a44c9415a7af435fc949dd913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acuity</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Astigmatism</topic><topic>Cell density</topic><topic>Collagen</topic><topic>Collagen - pharmacology</topic><topic>Cornea</topic><topic>Cornea - drug effects</topic><topic>Cornea - pathology</topic><topic>Cornea - surgery</topic><topic>Corneal Topography - methods</topic><topic>Corneal transplantation</topic><topic>Cross-Linking Reagents - pharmacology</topic><topic>Endothelial cells</topic><topic>Eye</topic><topic>Eye surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Keratoconus</topic><topic>Keratoconus - diagnosis</topic><topic>Keratoconus - therapy</topic><topic>Keratoplasty, Penetrating - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Ophthalmology</topic><topic>Patients</topic><topic>Photochemotherapy - methods</topic><topic>Refraction, Ocular</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Time Factors</topic><topic>Visual Acuity</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kubaloglu, Anıl</creatorcontrib><creatorcontrib>Sari, Esin Sogutlu</creatorcontrib><creatorcontrib>Koytak, Arif</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kubaloglu, Anıl</au><au>Sari, Esin Sogutlu</au><au>Koytak, Arif</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deep anterior lamellar keratoplasty in eyes previously treated with collagen crosslinking for keratoconus: 3-year results</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><stitle>Graefes Arch Clin Exp Ophthalmol</stitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>258</volume><issue>4</issue><spage>821</spage><epage>827</epage><pages>821-827</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><abstract>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
< 0.001). UCVA was 20/100 or lower in all eyes preoperatively and 20/100 or better in 18 eyes (80%) at 3 years; BSCVA was 20/40 or better in all eyes (100%) and 20/20 or better in three eyes (15%), and keratometric astigmatism was lower than 4 dioptres in 14 eyes (70%) at 3 years. The mean ECD loss was 6.3 ± 4.4% at 1 year, 9.0 ± 6.3% at 2 years and 11.2 ± 7.4% at 3 years.
Conclusion
Previous CXL treatment in keratoconus patients did not cause a negative impact on the visual, refractive and surgical outcomes of DALK surgery using the big-bubble technique. DALK surgery seems to be a safe and effective surgical approach in these patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31915972</pmid><doi>10.1007/s00417-019-04587-6</doi><tpages>7</tpages></addata></record> |
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| source | Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List |
| 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 |
| title | Deep anterior lamellar keratoplasty in eyes previously treated with collagen crosslinking for keratoconus: 3-year results |
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