Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 1-2, Pages: 88-91
https://doi.org/10.2298/SARH1102088N
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Deep anterior lamellar keratoplasty in keratoconus
Nikolić Ljubiša (Klinika za očne bolesti „Prof. dr Ivan Stanković”, Kliničko-bolnički centar „Zvezdara”, Beograd)
Jovanović Vesna (Klinika za očne bolesti „Prof. dr Ivan Stanković”, Kliničko-bolnički centar „Zvezdara”, Beograd)
Introduction. Deep anterior lamellar keratoplasty (DALK) is intended for the
surgical treatment of corneal pathology without the involvement of the
endothelium. Sparing of the healthy host endothelium for lifetime is of
utmost importance in young patients. Therefore, keratoconus is among the main
indications for DALK. Outline of Cases. Two men, 22 and 28 years of age,
underwent DALK for the treatment of progressive keratoconus, with low visual
acuity, impossible to be corrected with gas-permeable contact lenses, due to
the extreme conical protrusion of the cornea. Baring of Descemet’s membrane
was achieved with lamellar dissection and peeling off the stroma. An 8.5 mm
graft without the endothelium was sutured into an 8.0 mm bed. Both grafts
remained clear and attached, without either ocular surface pathology or
problems arising from sutures. The best corrected visual acuity was 20/25 and
20/40, with the astigmatism of 2.5 and 3.0 diopters, respectively. The
follow-up was one year. Conclusion. This is the first presentation of DALK in
our literature. The restoration of corneal transparency and stability, with
sparing of the host endothelium, has put DALK among successful corneal
tranplantation procedures. Together with Descemet stripping endothelial
keratoplasty, which already accounts for almost a half of all our
keratoplasties, it offers an alternative to penetrating keratoplasty.
Keywords: deep anterior lamellar keratoplasty, DALK, cornea, keratoconus, keratoplasty
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