Successful Deep Anterior Lamellar Keratoplasty in Pre-existing Descemet Membrane Perforation - A Case Series

S. Kodavoor, Bijita Deb, S. Balajee, R. Dandapani
{"title":"Successful Deep Anterior Lamellar Keratoplasty in Pre-existing Descemet Membrane Perforation - A Case Series","authors":"S. Kodavoor, Bijita Deb, S. Balajee, R. Dandapani","doi":"10.11648/J.IJOVS.20200503.11","DOIUrl":null,"url":null,"abstract":"Aim: To analyse the outcome of Deep anterior lamellar keratoplasty (DALK) in cases of pre-existing DM (Descemet membrane) tear. Method: 14 eyes with pre-existing perforation (4 eyes with advanced keratoconus post collagen crosslinking and post Toric implantable collamer lens explantation and 10 eyes with post healed hydrops) who underwent DALK were included. Manual layer by layer dissection by a special technique was employed. Results: Minimum follow up-1 year. All patients had good post-operative results with mean UCVA preoperative and postoperative value of 1.35±0.25 LogMAR and 0.68 ± 0.19 LogMAR respectively with ‘p’ value of 0.00001 which was significant. Mean astigmatism preoperative and postoperative was found to be 4.82±1.76D and 2.66±0.7D and ‘p’ value was significant (p=0.00042). Mean endothelial count preoperative and postoperative was 2479.18±239.42cells/cm2 and 2238.45±218.49cell/cm2 with percentage reduction of 9.6% at 1 year. Two eyes among them had postoperative double anterior chamber and two eyes had wrinkling of DM due to the advanced nature of KC. Conclusion: DALK can be successful in patients with pre-existing DM perforation if careful precautions are taken. Also layer by layer technique with a centripetal dissection is preferred in such cases to prevent intraoperative scar extension.","PeriodicalId":14184,"journal":{"name":"International Journal of Ophthalmology & Visual Science","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Ophthalmology & Visual Science","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.11648/J.IJOVS.20200503.11","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Aim: To analyse the outcome of Deep anterior lamellar keratoplasty (DALK) in cases of pre-existing DM (Descemet membrane) tear. Method: 14 eyes with pre-existing perforation (4 eyes with advanced keratoconus post collagen crosslinking and post Toric implantable collamer lens explantation and 10 eyes with post healed hydrops) who underwent DALK were included. Manual layer by layer dissection by a special technique was employed. Results: Minimum follow up-1 year. All patients had good post-operative results with mean UCVA preoperative and postoperative value of 1.35±0.25 LogMAR and 0.68 ± 0.19 LogMAR respectively with ‘p’ value of 0.00001 which was significant. Mean astigmatism preoperative and postoperative was found to be 4.82±1.76D and 2.66±0.7D and ‘p’ value was significant (p=0.00042). Mean endothelial count preoperative and postoperative was 2479.18±239.42cells/cm2 and 2238.45±218.49cell/cm2 with percentage reduction of 9.6% at 1 year. Two eyes among them had postoperative double anterior chamber and two eyes had wrinkling of DM due to the advanced nature of KC. Conclusion: DALK can be successful in patients with pre-existing DM perforation if careful precautions are taken. Also layer by layer technique with a centripetal dissection is preferred in such cases to prevent intraoperative scar extension.
成功的深前板层角膜移植术治疗预先存在的视网膜膜穿孔-一个案例系列
目的:分析深前板层角膜移植术(DALK)治疗糖尿病(DM)撕裂的效果。方法:选取已有穿孔的14眼(4眼为晚期圆锥角膜,术后胶原交联,术后环形晶状体植入术,术后积液愈合者10眼)行DALK手术。采用一种特殊的手工逐层解剖技术。结果:最短随访1年。所有患者术后效果良好,术前、术后平均UCVA分别为1.35±0.25 LogMAR和0.68±0.19 LogMAR, p值为0.00001,差异有统计学意义。术前、术后平均散光分别为4.82±1.76D、2.66±0.7D, p值差异有统计学意义(p=0.00042)。平均内皮细胞计数术前和术后分别为2479.18±239.42cells/cm2和2238.45±218.49 cells/cm2, 1年减少9.6%。其中2只眼术后双前房,2只眼因KC的先进性出现DM的起皱。结论:在注意预防的前提下,DALK可以成功治疗已存在DM穿孔的患者。在这种情况下,为了防止术中瘢痕扩大,首选向心剥离的逐层技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信