Deep anterior lamellar keratoplasty with Intacs explantation in keratoconus.
OBJECTIVE
To describe the surgical technique and clinical outcome of deep anterior lamellar keratoplasty (DALK) with Intacs explantation in patients with poor visual outcome after Intacs implantation for keratoconus correction.


METHODS
Two patients with bilateral keratoconus underwent Intacs segment implantation. Due to poor visual outcome and patient dissatisfaction, the Intacs segments were explanted and a big bubble-assisted DALK procedure was performed at the time of Intacs removal.


RESULTS
DALK could be successfully completed in both cases. There were no postoperative complications. At 2 years follow-up, the grafts were clear in both patients, with a best spectacle-corrected visual acuity of 20/25.


CONCLUSIONS
A modified big bubble-assisted DALK procedure can be performed in keratoconic eyes requiring Intacs explantation and may provide a better alternative to a penetrating keratoplasty.
Titiyal
Jeewan S
JS
Cornea and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Chawla
Bhavna
B
Sharma
Namrata
N
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D016039:Corneal Transplantation; D020878:Device Removal; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D016896:Treatment Outcome; D014786:Vision Disorders / Q000601:surgery; D014792:Visual Acuity; D055815:Young Adult
D019904:Polymethyl Methacrylate