Air-guided manual deep anterior lamellar keratoplasty: long-term results and confocal microscopic findings.
OBJECTIVE
To evaluate the long-term results of air-guided manual deep anterior lamellar keratoplasty (DALK) and to perform confocal microscopy on postoperative DALK corneas.


METHODS
Seven postoperative consecutive DALK corneas were evaluated 1 year after suture removal. All patients underwent a complete ophthalmologic examination evaluating visual acuity, astigmatism, corneal thickness, and endothelial cell count. Confocal microscopy was performed to examine the corneas of the seven eyes and to obtain the measured interface depth.


RESULTS
Eighteen months after surgery, the mean postoperative uncorrected visual acuity was 20/38 and the mean best-corrected visual acuity was 20/23. Postoperative mean value of residual recipient stroma thickness was 65.57 microm +/- 28.74.


CONCLUSIONS
Maximum depth DALK can lead to significant advantages for quality of vision when compared to other types of anterior lamellar keratoplasty. Still, it remains a challenging procedure. These results show that a deep dissection without baring Descemet membrane makes good visual results possible, preventing corneal perforation and conversion to penetrating graft.
Balestrazzi
A
A
Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy. balestrazzi@unisi.it
Malandrini
A
A
Traversi
C
C
Martone
G
G
Caporossi
A
A
D000328:Adult; D000388:Air; D002452:Cell Count; D003315:Cornea / Q000294:innervation; D003319:Corneal Stroma / Q000294:innervation / Q000473:pathology; D016039:Corneal Transplantation / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology* / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009882:Ophthalmic Nerve / Q000473:pathology; D016896:Treatment Outcome; D014792:Visual Acuity