Deep anterior lamellar keratoplasty with dehydrated, 4 °C-stored, and rehydrated lenticules.
OBJECTIVE
To retrospectively evaluate the outcomes of 124 consecutive deep anterior lamellar keratoplasties (DALK) performed by using dehydrated, 4 °C stored, and rehydrated lenticules.


METHODS
A total of 124 eyes of 109 patients, which had undergone DALK from August 11, 2000, to December 13, 2007, were included in our retrospective study; 88 cases were male and 36 female, with a mean age of 39.45±15.52 years (range 6-85). A total of 109 (87.9%) had keratoconus, 7 (5.6%) had deep or superficial corneal scar, 3 (2.4%) had epikeratophakia, 3 (2.4%) had pellucid degeneration, 1 (0.8%) a malignant pterygium, and 1 (0.8%) had a severe alkali burn. All the patients underwent ophthalmic examinations, including best-corrected visual acuity (BCVA), central ultrasound pachymetry, computerized topography, specular microscope endothelial cell count, and confocal microscopy.


RESULTS
The mean follow-up was 23.9±3.4 months. The mean preoperative BCVA was 0.16±0.18; the postoperative BCVA was 0.68±0.20 after 2 years. The mean preoperative central corneal thickness (CCT) was 439.4±10.5 µm; after 2 years, it was 532.1±9.7 µm. The mean preoperative endothelial cell count (ECC) was 2301.3±180.2 cells/mm2; after 2 years it was 1986.0±169.5 with a decrease of 13.7%. Baring of Descemet membrane (DM) during DALK was achieved in 112 (90.32%) eyes; 4 eyes (3.26%) had a large perforation of the DM with consequent PK. Small intraoperative perforation of DM during DALK occurred in 18 cases (14.52%).


CONCLUSIONS
The results showed that the method of preservation and distribution of dehydrated, 4 °C stored, and rehydrated lenticules is safe, cheap, and simple. Furthermore, it does not appear to influence the outcomes of the DALK surgery.
Department of Ophthalmology, S. Maria della Scaletta Hospital, Imola, Bologna, Italy.
Paolo
P
Bonci
Vincenzo
V
Della Valle
Paola
P
Bonci
Roberto
R
Lodi
Alessandra
A
Russo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D002648:Child; D003315:Cornea; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D015925:Cryopreservation; D003890:Desiccation; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009926:Organ Preservation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology