Deep anterior lamellar keratoplasty techniques; predescemetic versus big bubble: Anterior segment optical coherence tomography study Étude comparative à la tomographie par cohérence optique de la dissection intrastromale pre-descemétique manuelle classique et la technique de la big bubble dans la kératoplastie lamellaire antérieure profonde
Journal Francais d'Ophtalmologie, cilt.43, sa.3, ss.222-227, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 43 Sayı: 3
- Basım Tarihi: 2020
- Doi Numarası: 10.1016/j.jfo.2019.08.004
- Dergi Adı: Journal Francais d'Ophtalmologie
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
- Sayfa Sayıları: ss.222-227
- Anahtar Kelimeler: Deep anterior lamellar keratoplasty, Keratoconus, Pre-Descemet's, Big bubble, OCT
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: To compare the visual and refractive outcomes and anterior segment optical coherence tomography (AS-OCT) findings of 2 different deep anterior lamellar keratoplasty (DALK) techniques in the treatment of advanced keratoconus with and without successful big bubble formation. Methods: In this retrospective comparative case series, data from 79 consecutive eyes of 69 patients who underwent either big bubble (group 1, n: 62) or manual DALK (group 2, n: 17) were analyzed. The visual and refractive results, keratometric values and residual stromal thickness were assessed. Patients were seen at 1, 3, 6 and 12 months after the procedure and 1 month after complete suture removal. Results: A big bubble was successfully obtained in 62 eyes (78.5%; group 1) and manual dissection was performed in the 17 remaining eyes (21.5%; group 2). The final best spectacle-corrected visual acuity (BSCVA) was 0.38 logMAR and 0.55 logMAR in Group 1 and 2, respectively (P < 0.05). At the final visit, BSCVA ≤ 0.30 logMAR was achieved in 80% and 60.8% of eyes in Groups 1 and 2, respectively (P < 0.001). Groups 1 and 2 were comparable in terms of mean keratometry: 47.80D ± 2.81D (range, 41.30D to 54.2D) versus 45.90D ± 3.62D (range, 41.10D to 53.8 D), respectively; (P = 0.56) and keratometric astigmatism: 3.81D± 2.1D (range, 1.0D to 6.20D) versus 3.56D ± 1.92D (range 1.2D to 6.85D), respectively; (P = 0.40) at the final follow-up. The mean residual stromal thickness was 36.90 ± 17.80 μm in group 2. Conclusion: The presence of residual posterior corneal stroma when big bubble formation is not successfully achieved in DALK is correlated with lower postoperative visual acuity.