Deep anterior lamellar keratoplasty by a new complete muticous intrastromal separation

Abstract

Objective To evaluate the efficacy and safety of the deep anterior lamellar keratoplasty(DALK)in the treatment of keratonosus through a new surgical technique-complete muticous intrastromal separation assisted by iris repositor.Methods Through complete muticous intrastromal separation,DALK was performed in 35 patients(35 eyes)of keratonosus without endothelial abnormalities.The effectiveness of operation was clinically observed and evaluated.Results During surgery,two eyes(5.71%)had mini-rupture of the DM and were finished by reserving few deep stroma.Two eyes(5.71%)occurred double anterior chamber after surgery and were absorption in three days.All of bacterial and fungal keratitis was not occurred recurrence.Eighteen cases of bacterial and fungal keratitis were not occurred recurrence.Eighteen cases of BCVA were over 0.5(51.4%)and 25 cases were over 0.3(71.4%)at two weeks after suture removal.Topographic astigmatism showed a decrease tendency,but endothelium cell density were not evident change at different postoperative times.Kerato-graft was clarity without evident intrastromal opacity at 6 month after surgery.Conclusions The DALK by complete muticous intrastromal separation is a safe and effective therapy in the treatment of keratonosus.Laser Confocal Microscopy enables precise evaluation of corneal features,provide a favorable objective evidence for DALK. Key words: Lamellar keratoplasty:Laser confocal microscopy:Keratonosus.