title: Comparative study of keratoconus between Anwar's deep anterior lamellar keratoplasty versus converted penetrating keratoplasty.
abstract: OBJECTIVE
  To compare outcomes between penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) in patients with keratoconus.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Data of 90 DALK and 49 procedures from conversion to PK, performed by a single surgeon (R.D.) from 2006 to 2011 were analysed. Outcomes on corrected distance visual acuity (BCVA), astigmatism, time to first refraction, pachymetry, endothelial count cell, and postoperative complications were compared between these groups.
  
  
  RESULTS
  The mean age of the patients who underwent DALK and PK was 28.2 and 31.7 years, respectively (P=.17). The mean follow up for DALK and for the PK group was 14.7 and 19.4 months, respectively (P=.13). There was no significant difference between PK and DALK groups in the mean postoperative for: BCVA (LogMAR) (0.17 vs. 0.17; P=.59); refractive astigmatism (-3.19 vs.-3.01 diopters; P=.65), and time for the first subjective refraction (60.5 versus 68 days; P=.50). Main postoperative complications were 8% of endothelial rejection in PK group and 10% of deep stromal vascularization in DALK group.
  
  
  CONCLUSIONS
  The only differences in postoperative results between groups were stromal neovascularization in DALK group and endothelial rejection in PK group. DALK should be considered as the first option when keratoplasty is indicated in keratoconus.
authors.affiliation: Clínica Oftalmológica Pasteur, Santiago, Chile. Electronic address: rdonoso@pasteur.cl.
authors.forename: R
authors.initials: R
authors.lastname: Donoso
authors.affiliation: Hospital Salvador, Universidad de Chile, Santiago, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Díaz
authors.affiliation: Hospital Salvador, Universidad de Chile, Santiago, Chile.
authors.forename: P
authors.initials: P
authors.lastname: Villavicencio
mesh_terms: D000293:Adolescent; D000328:Adult; D003315:Cornea / Q000648:ultrastructure; D016039:Corneal Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D042783:Endothelial Cells; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Big Bubble; Conversion; Conversión; Deep anterior lamellar keratoplasty; Gran burbuja; Keratoconus; Penetrating keratoplasty; Queratocono; Queratoplastia lamelar anterior profunda; Queratoplastia penetrante