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Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty

PURPOSE: To describe a modified deep anterior lamellar keratoplasty (DALK) technique to rescue failed penetrating keratoplasty (PK) grafts and report its results. PATIENTS AND METHODS: Retrospective, case-series analysis of patients who underwent modified DALK to rescue failed corneal grafts after P...

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Autores principales: Lisa, Carlos, Machado Soares, Ricardo, Fernández-Vega-Cueto, Luis, Alfonso-Bartolozzi, Belén, Alfonso, Jose F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675345/
https://www.ncbi.nlm.nih.gov/pubmed/36411873
http://dx.doi.org/10.2147/OPTH.S382916
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author Lisa, Carlos
Machado Soares, Ricardo
Fernández-Vega-Cueto, Luis
Alfonso-Bartolozzi, Belén
Alfonso, Jose F
author_facet Lisa, Carlos
Machado Soares, Ricardo
Fernández-Vega-Cueto, Luis
Alfonso-Bartolozzi, Belén
Alfonso, Jose F
author_sort Lisa, Carlos
collection PubMed
description PURPOSE: To describe a modified deep anterior lamellar keratoplasty (DALK) technique to rescue failed penetrating keratoplasty (PK) grafts and report its results. PATIENTS AND METHODS: Retrospective, case-series analysis of patients who underwent modified DALK to rescue failed corneal grafts after PK was included. Every patient had corneal graft failure (GF) diagnosis due to anterior corneal (epithelium, Bowman’s, and stroma layers) or refraction disorders uncorrectable with conservative management. The main objective of the surgery and primary outcome of the study was the improvement of corrected distance visual acuity (CDVA). The study’s secondary outcome was the frequency of intra- and postoperative complications. RESULTS: This series included four eyes from three patients with a mean age of 57.7 years (range: 51–63 years). Mean follow-up of patients was thirteen months (range: 12–15 months). During follow-up, continuous improvement of corneal transparency and CDVA was observed in every patient. The only intraoperative complication reported was a peripheric DM microperforations of previous graft–host junction in two eyes. No signs of double anterior chamber, endothelial failure, GF, glaucoma, or other side effects were reported. CONCLUSION: Our results suggest that modified DALK in patients with GF after PK, preserving a healthy endothelium, is surgically feasible. However, further studies are needed to compare this procedure to PK and other DALK technique variations.
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spelling pubmed-96753452022-11-20 Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty Lisa, Carlos Machado Soares, Ricardo Fernández-Vega-Cueto, Luis Alfonso-Bartolozzi, Belén Alfonso, Jose F Clin Ophthalmol Original Research PURPOSE: To describe a modified deep anterior lamellar keratoplasty (DALK) technique to rescue failed penetrating keratoplasty (PK) grafts and report its results. PATIENTS AND METHODS: Retrospective, case-series analysis of patients who underwent modified DALK to rescue failed corneal grafts after PK was included. Every patient had corneal graft failure (GF) diagnosis due to anterior corneal (epithelium, Bowman’s, and stroma layers) or refraction disorders uncorrectable with conservative management. The main objective of the surgery and primary outcome of the study was the improvement of corrected distance visual acuity (CDVA). The study’s secondary outcome was the frequency of intra- and postoperative complications. RESULTS: This series included four eyes from three patients with a mean age of 57.7 years (range: 51–63 years). Mean follow-up of patients was thirteen months (range: 12–15 months). During follow-up, continuous improvement of corneal transparency and CDVA was observed in every patient. The only intraoperative complication reported was a peripheric DM microperforations of previous graft–host junction in two eyes. No signs of double anterior chamber, endothelial failure, GF, glaucoma, or other side effects were reported. CONCLUSION: Our results suggest that modified DALK in patients with GF after PK, preserving a healthy endothelium, is surgically feasible. However, further studies are needed to compare this procedure to PK and other DALK technique variations. Dove 2022-11-15 /pmc/articles/PMC9675345/ /pubmed/36411873 http://dx.doi.org/10.2147/OPTH.S382916 Text en © 2022 Lisa et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Lisa, Carlos
Machado Soares, Ricardo
Fernández-Vega-Cueto, Luis
Alfonso-Bartolozzi, Belén
Alfonso, Jose F
Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty
title Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty
title_full Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty
title_fullStr Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty
title_full_unstemmed Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty
title_short Modified Deep Anterior Lamellar Keratoplasty Technique to Rescue Failed Penetrating Keratoplasty
title_sort modified deep anterior lamellar keratoplasty technique to rescue failed penetrating keratoplasty
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675345/
https://www.ncbi.nlm.nih.gov/pubmed/36411873
http://dx.doi.org/10.2147/OPTH.S382916
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