Deep anterior lamellar transplant using lyophilized and Optisol corneas in patients with keratoconus.
OBJECTIVE
Prospective randomized clinical trial to evaluate the efficacy of lyophilized corneas for deep anterior lamellar keratoplasty (DALK) in patients with keratoconus.


METHODS
Ten eyes underwent DALK and received corneas that had been lyophilized, and 10 eyes received corneas kept in Optisol. Follow-up examinations included measurement of visual acuity (VA; Early Treatment Diabetic Retiropathy Study chart), topography, pachymetry, specular microscopy, contrast sensitivity, and confocal microscopy.


RESULTS
All variables improved similarly in both groups, without statistical differences between them, except for the uncorrected VA in the sixth postoperative month, which was better in the lyophilized group (0.46) compared with the Optisol group (0.70). The best spectacle-corrected VA was 0.16 in the lyophilized group and 0.26 in the Optisol group. The mean endothelial cell count during the sixth postoperative month was 2778.5 in the lyophilized group and 2611.5 in the Optisol group. Optisol corneas had greater keratocyte density, and the keratocyte density improved in lyophilized corneas during follow-up.


CONCLUSIONS
Lyophilized corneas can be used successfully for DALK to treat keratoconus with results similar to Optisol corneas.
Farias
Roberta
R
Federal University of São Paulo, São Paulo, Brazil. roberta.farias@yahoo.com.br
Barbosa
Luciene
L
Lima
Acácio
A
Mayumi
Eliane
E
Lourenço
Andréa
A
de Freitas
Denise
D
Allemann
Norma
N
Vieira
Luís
L
D000328:Adult; D002809:Chondroitin Sulfates / Q000494:pharmacology*; D045424:Complex Mixtures / Q000494:pharmacology; D003315:Cornea / Q000187:drug effects* / Q000473:pathology; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000009:adverse effects / Q000379:methods*; D016895:Culture Media, Serum-Free / Q000494:pharmacology*; D003911:Dextrans / Q000494:pharmacology*; D005139:Eyeglasses; D005500:Follow-Up Studies; D005612:Freeze Drying; D005839:Gentamicins / Q000494:pharmacology*; D006801:Humans; D007634:Keratitis / Q000209:etiology; D007640:Keratoconus / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D018613:Microscopy, Confocal; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
D045424:Complex Mixtures; D016895:Culture Media, Serum-Free; D003911:Dextrans; D005839:Gentamicins; D002809:Chondroitin Sulfates; C075736:Optisol