Comparision of deep anterior lamellar keratoplasty results in different TGFβI corneal dystrophies

Abstract

Abstract Purpose To compare the results of deep anterior lamellar keratoplasty in eyes with TGFβI corneal dystrophies. Methods 10 eyes of 8 patients with TGFβI corneal dystrophies after DALK were recruited for the study. There were 5 eyes with LCD1 (R124C), 2 eyes with atypical LCD (H626R), 2 eyes with TBCD (R555Q), and 1 eye with GCD1 (R555W). Main outcome measures were: complication noticed during Descemet membrane air dissection, 6 month graft and stromal bed clarity, presence of stromal bed folds during OCT exam, best corrected visual acuity (BCVA), corneal astigmatism and endothelial cell density (ECD). Results Local Descemet membrane perforation during DALK occurred in 1 eye with R555W mutation and 2 eyes with H626R mutation. Descemet membrane detachment was diagnosed postoperatively in one eye with R124C mutation. DMD resolved spontaneously within one month. At 6 month all grafts reminded clear, but there were thick stromal bed folds visible during OCT exam in 1 eye with R555W mutation and 2 eyes with H626R mutation. BCVA was 0,8 in eyes with R555Q, 0,4 in eyes with R124C, 0,2 in eyes with H626R and 0,3 in eye with R555W mutation. There were no differences noticed in corneal astigmatism or ECD at 6 month. Mean corneal astigmatism was 3,3 D (± 0,43) and ECD was 2156 cells/mm2 (± 758). Conclusion The TGFβI dystrophy type influences on the results after DALK. TBCD and LCD1 with no deep stromal or Descemet involvement are good candidates for DALK.