Effect of Keratoconus Severity on Clinical outcomes after Deep Anterior Lamellar Keratoplasty
Publish Year: 1397
نوع سند: مقاله کنفرانسی
زبان: English
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شناسه ملی سند علمی:
ACSOMED28_104
تاریخ نمایه سازی: 1 دی 1397
Abstract:
Purpose: To evaluate the effect of keratoconus severity on visual and refractive outcomes and complications after deep anterior lamellar keratoplasty (DALK). Methods: This consecutive interventional case series enrolled 227 keratoconus-affected eyes that underwent DALK. The Amsler-Krumeich keratoconus classification was used to categorize the patients: stage II, 47 eyes; stage III, 60 eyes; and stage IV, 120 eyes. The outcome measures including postoperative best-spectacle corrected visual acuity (BSCVA), spherical equivalent refraction, mean keratometry, keratometric astigmatism, and complications were analyzed and compared according to keratoconus stage.Results: The mean patient age was 27.6±8.0 years and the mean follow-up period was 38.0±19.8 months. No significant differences were observed in postoperative BSCVA (P=0.55), spherical equivalent refraction (P=0.27), mean keratometry (P=0.09), and keratometric astigmatism (P=0.14) among the groups. Changes in BSCVA were significantly greater in stage III and stage IV than in stage II (P=0.04 and <0.001, respectively). The decrease in spherical equivalent was significantly greater in stages III and IV than in stage II (P=0.04 and 0.001, respectively). Mean keratometry decreased to a greater degree in stage IV than in stages II and III (P<0.001 for both comparisons). The study groups were comparable with respect to intraoperative Descemet membrane perforation, suture-related complications, and graft rejection. Conclusion: DALK is a safe and effective procedure for the treatment of keratoconus of all stages. This technique of corneal transplantation is more effective in eyes with severe keratoconus than those with moderatekeratoconus.
Authors
Sepehr Feizi
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences
Mohammad Ali Javadi
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences
Bahareh Kheiri
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences