November 10, 2014
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DALK restores corrected distance vision after post-LASIK keratectasia

Deep anterior lamellar keratoplasty restored corrected distance vision in patients with post-LASIK keratectasia, despite a high prevalence of residual ametropia, according to a study.

The retrospective study included 20 eyes of 18 patients who underwent DALK for post-LASIK keratectasia using the Melles manual technique. DALK was performed unilaterally in 16 patients and bilaterally in two patients. Mean follow-up was 31.8 months.

Mean Snellen corrected distance visual acuity improved from 20/191 preoperatively to 20/23 postoperatively; the improvement was statistically significant (P < .001).

The mean modulus of spherical equivalent refraction was 6.8 D before LASIK, 12.5 D before DALK and 11.2 D after DALK. The differences between the pre-LASIK and pre-DALK values (P = .004) and pre-LASIK and post-DALK values (P = .001) were statistically significant.

Mean keratometry value decreased from 52.2 D before DALK to 46 D after DALK (P = .001). Mean apical keratometry value also decreased significantly, from 59.5 D to 49.9 D (P < .001).

Mean keratometric astigmatism decreased from 4.3 D to 1.9 D (P = .003).

No serious DALK-related complications were reported, and there were no significant changes in endothelial cell profiles.

Subsequent surgery to correct residual ametropia was performed in 12 eyes.

Disclosure: Melles is a consultant to D.O.R.C. International/Dutch Ophthalmic USA. The remaining authors have no relevant financial disclosures.