DALK corneal grafts may survive longer than PK corneal grafts

Long-term graft survival is better with deep anterior lamellar keratoplasty than penetrating keratoplasty, according to a study.

“Although PK seems very successful with an overall survival rate of 90% at 5 years, the overall success rate progressively diminishes at 10 years and continues to decrease dramatically when regraft is necessary,” the study authors said.

In a retrospective review of 660 consecutive DALK procedures to treat corneal disorders in 502 patients, corneal graft survival rates were examined for up to 10 years. Follow-up ranged from 6 months to 10 years, with a mean of 4.5 years.

Patients were examined by the study authors for 6 months postoperatively, and then patients were seen by their own ophthalmologists.

Graft clarity was used to judge graft survival, and irreversible opacification of the graft meant the graft was a failure.

The average graft survival rate was 99.3%, and graft failure occurred in three cases. There was an average endothelial cell loss of 11% from 6 months through 10 years. There was no change in endothelial cell density between 6 months and last follow-up.

This study was the largest series of reported graft survival cases after DALK, the authors said.

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Source:

Cornea. 2012;31(6):621-626.