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DALK may improve visual acuity in children with advanced keratoconus
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Children with advanced keratoconus who underwent deep anterior lamellar keratoplasty showed improvements in visual acuity, according to a study.
The retrospective, noncomparative case series included 20 eyes of 16 children who underwent DALK.
At the time of surgery, all children had keratoconus of stage 3 or higher based on the Krumeich classification. Hydrops were not observed in any eyes.
Follow-up ranged from 24 months to 105 months, with a mean of 44.5 months.
Mean decimal uncorrected visual acuity improved from 0.06 preoperatively to 0.24 at final follow-up, and mean decimal best corrected visual acuity improved from 0.12 to 0.45.
Mean keratometry decreased from 64.15 D preoperatively to 45.7 D after surgery.
At the final follow-up visit, 18 eyes had clear grafts in the visual axis area, mean endothelial cell count was 2,179 cells/mm2, and mean IOP was 14 mm Hg.
Complications included one case of graft rejection, two cases of shield ulcers, two cases of graft infection and four cases of interface vascularization. After management of the complications, one patient underwent penetrating keratoplasty.
“Rejections, commonly encountered after PK, were rare events after DALK, thereby increasing the success rate of the corneal graft. Counseling and making the parents aware of any possible complications and postoperative medication regimen adds to the graft’s success,” the study authors said. – by Nhu Te
Disclosure: The authors report no relevant financial disclosures.
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Arora R, et al. Am J Ophthalmol. 2016;doi:10.1016/j.ajo.2015.11.020
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