Comparison of Deep Lamellar Keratoplasty and Penetrating Keratoplasty in Patients with Keratoconus: A Clinical Trial Study

Document Type : Original Article(s)

Authors

1 Professor, Department of Ophthalmology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Ophthalmology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Isfahan Medical Students Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: There are different surgical methods for the treatment of patients with keratoconus. The aim of this study was to compare deep lamellar keratoplasty (DLK) and penetrating keratoplasty (PK) methods.Methods: This clinical trial was performed between 2009 and 2011 on 30 Iranian patients. Subjects were recruited consecutively in Feiz hospital, Isfahan, Iran and were randomly entered two groups (each one including 15 cases) under the treatment of DLK or PK.Findings: Two groups (DLK vs. PK) were matched in age (29.4 ± 2.3 vs. 30.9 ± 4.1, P = 0.61) and sex (P = 0.23). Best-corrected visual acuity (BCVA) was decreased significantly in both groups and no difference was found between the decline level between the groups (P = 0.142). Also, regarding improvement of refractive problems, no difference was observed in decline of spherical equivalent (P = 0.533) and astigmatism (P = 0.791). Mean time of suture removal was significantly (P < 0.001) lower in DLK group (6.20 ± 2.11 months) versus PK group (10.93 ± 2.40 months). No complications were observed during both procedures. However, after PK, four cases complicated with endothelial rejection and one with graft failure. Also, after DLK, one case with interface neovascularization and another with stromal rejection were observed.Conclusion: Both methods are effective in reducing the refractive status of keratoconus patients and result in proper BCVA improvement. However, DLK seems to have more successfulness and fewer complications. 

Keywords

References

  1. Graves B. "KERATOCONUS". Br J Ophthalmol 1925; 9(1): 45.
  2. Knapp A. Etiology and Treatment of Kerato-conus. Trans Am Ophthalmol Soc 1929; 27: 63-72.
  3. Ridley F. Contact Lenses in Treatment of Kerato-conus. Br J Ophthalmol 1995; 40(5): 295-304.
  4. Tuft SJ, Gregory WM, Davison CR. Bilateral penetrating keratoplasty for keratoconus. Ophthalmology 1995; 102(3): 462-8.
  5. Sugar A, Sugar J. Techniques in penetrating keratoplasty: a quarter century of development. Cornea 2000; 19(5): 603-10.
  6. Kanavi MR, Javadi MA, Sanagoo M. Indications for penetrating keratoplasty in Iran. Cornea 2007; 26(5): 561-3.
  7. Panda A, Bageshwar LM, Ray M, Singh JP, Kumar A. Deep lamellar keratoplasty versus penetrating keratoplasty for corneal lesions. Cornea 1999; 18(2): 172-5.
  8. Price FW, Price MO. Adult keratoplasty: has the prognosis improved in the last 25 years? Int Ophthalmol 2008; 28(3): 141-6.
  9. Shimmura S, Tsubota K. Deep lamellar keratoplasty. Am J Ophthalmol 2006; 141(2): 352-3.
  10. Anwar M, Teichmann KD. Deep lamellar keratoplasty: surgical techniques for anterior lamellar keratoplasty with and without baring of Descemet's membrane. Cornea 2002; 21(4): 374-83.
  11. Watson SL, Ramsay A, Dart JK, Bunce C, Craig E. Comparison of deep lamellar keratoplasty and penetrating keratoplasty in patients with keratoconus. Ophthalmology 2004; 111(9): 1676-82.
  12. Vabres B, Bosnjakowski M, Bekri L, Weber M, Pechereau A. Deep lamellar keratoplasty versus penetrating keratoplasty for keratoconus. J Fr Ophtalmol 2006; 29(4): 361-71. [In French].
  13. Roos RA, Jongen JC, van der Velde EA. Clinical course of patients with idiopathic Parkinson's disease. Mov Disord 1996; 11(3): 236-42.
  14. Funnell CL, Ball J, Noble BA. Comparative cohort study of the outcomes of deep lamellar keratoplasty and penetrating keratoplasty for keratoconus. Eye (Lond) 2006; 20(5): 527-32.
  15. Han DC, Mehta JS, Por YM, Htoon HM, Tan DT. Comparison of outcomes of lamellar keratoplasty and penetrating keratoplasty in keratoconus. Am J Ophthalmol 2009; 148(5):744-51.
  16. Fontana L, Parente G, Tassinari G. Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus. Am J Ophthalmol 2007; 143(1): 117-24.
Journal of Isfahan Medical School
Volume 29, Issue 144 - Serial Number 144
May and June 2011
Pages 798-803

Files

History

  • Receive Date: 21 June 2011
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics