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DALK with or without Descemet's membrane baring yields comparable final outcomes
Cornea. 2010;29(11):1252-1255.
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Patients who underwent Anwar's deep anterior lamellar keratoplasty without baring Descemet's membrane had delayed visual recovery but eventually achieved the visual results of patients who received DALK with baring of Descemet's membrane, according to a study.
A total of 123 keratoconic eyes were enrolled in the retrospective comparative study. In group 1, a bared Descemet's membrane was achieved in 100 eyes, and in group 2, 23 eyes had some posterior stroma left in place.
At months 1, 3, 6 and 12, postoperative best corrected visual acuity was significantly better in group 1 than in group 2, but no significant difference between the groups was found at final examinations.
The groups were also similar regarding keratometric astigmatism and spherical equivalent refractive error throughout follow-up.
"Air-assisted manual dissection DALK can be considered as an acceptable alternative to Anwar's technique when a bared [Descemet's membrane] cannot be achieved," the authors said. "To better understand the possible impact of retained recipient stroma after DALK on visual functions, however, it is advisable to conduct a similar study comparing [contrast sensitivity function] and [higher-order aberrations] between the study groups."