Retrospective contralateral study comparing deep anterior lamellar keratoplasty with penetrating keratoplasty: a patient's perspective

Objective: To compare the visual outcomes and the perspective of patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PKP) in the contralateral eyes of a cohort of patients. Design: Retrospective comparative case series. Participants: Ten patients (20 eyes) who underwent DALK in 1 eye and PKP in the fellow eye. Methods: In this fellow eye, comparative retrospective case series, visual outcomes were compared in 10 patients (20 eyes) who underwent DALK in 1 eye and PKP in their fellow eye between 1995 and 2009. Visual and refractive outcomes including higher-order aberrations were assessed. Patient satisfaction for both procedures was evaluated using a subjective questionnaire. Results: There was no significant difference in visual or refractive outcomes between the procedures. However, 8 of 10 patients (80%) preferred the PKP eye for vision and overall satisfaction (p = 0.02). Mean follow-up time for the PKP group was 8.4 +/- 4.5 years (median, 8.5 years; range, 3-17 years), whereas the mean follow-up time for the DALK group was 2.5 +/- 1.6 years (median, 2 years; range, 1-6 years) (p = 0.01). The intra- and postoperative complication rates were low and comparable between both procedures. Conclusions: More patients prefer the PKP-operated eye when compared with the DALK-operated eye, although there were no significant differences in visual and refractive outcomes between the 2 procedures.