Clinical Outcome After Deep Anterior Lamellar Keratoplaty Uing the Big-bubble Technique in Patient With Keratoconu Original Reearch Article

Purpoe To report clinical outcome of deep anterior lamellar keratoplaty (DALK) uing the big-bubble technique in patient with keratoconu. Deign Propective noncomparative interventional tudy. Method etting: ingle hopital. patient: Eighty-one unelected conecutive patient with moderate to advanced keratoconu intolerant to contact lene and with poor pectacle-corrected viual acuity. intervention: DALK big-bubble technique. main outcome meaure: Intraoperative and potoperative complication, potoperative uncorrected viual acuity (UCVA), bet pectacle-corrected viual acuity (BCVA), manifet refraction, corneal topography, and endothelial cell denity. Reult eventy-eight procedure (96%) were completed a DALK. Big-bubble wa achieved in 50 cae (64%); 28 (36%) required manual intratromal diection. Intraoperative microperforation occurred in 11 cae (13%). Baeline mean uncorrected viual acuity wa 20/500 and 20/60 two year after urgery. Average preoperative BCVA, wa 20/100 and 20/30 at the end of follow-up. Final BCVA wa better in patient in whom big-bubble with expoure of the Decemet membrane wa achieved (P < .05). Average keratometry and D (tandard deviation) refraction changed from 62.1 ± 6.7 diopter and −10.76 ± 5 diopter to 47.51 ± 4.73 diopter and −1.81 ± 3.2 diopter, repectively after urgery. Mean preoperative endothelial cell denity wa 2202.29 ± 392.35 cell/mm2 and 2034 ± 438.39 cell/mm2 two year after urgery. Two patient developed tromal rejection. Concluion The DALK big-bubble technique i a valuable treatment in patient with keratoconu. Viual outcome i comparable to tandard penetrating keratoplaty (PK) when formation of big-bubble with expoure of the Decemet membrane (DM) wa achieved. Clinically important graft-hot interface developed in ome cae after manual intratromal diection. tromal rejection i a rare complication.