Penetrating keratoplasty versus deep anterior lamellar keratoplasty for the treatment of keratoconus

被引：42

作者：

Cohen A.W. ^{[1
]}

Goins K.M. ^{[1
]}

Sutphin J.E. ^{[1
,2
]}

Wandling G.R. ^{[1
]}

Wagoner M.D. ^{[1
]}

机构：

[1] Department of Ophthalmology and Visual Sciences, University of Iowa, Carver College of Medicine, Iowa City, IA 52242-1091

[2] Department of Ophthalmology, University of Kansas, Medical Center, Kansas City, KS

来源：

International Ophthalmology | 2010年 / 30卷 / 6期

关键词：

Deep anterior lamellar keratoplasty; Keratoconus; Penetrating keratoplasty;

D O I：

10.1007/s10792-010-9393-9

中图分类号：

学科分类号：

摘要：

Purpose: To compare the outcome of penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) in the surgical management of keratoconus (KC). Patient and methods: A retrospective review was conducted of the medical records of all patients treated with PKP or DALK for KC at University of Iowa Hospitals and Clinics from January 1, 2000, to December 31, 2006. The main outcome measures were visual outcome, graft survival, and complications. Cases with a minimum follow-up of 6 months were included in the statistical analysis. Results: Of 41 eyes that met the inclusion criteria, 30 eyes were treated with PKP and 11 eyes were treated with DALK. The mean follow-up was almost identical for eyes treated with PKP or DALK (21.9 vs. 22.5 months, respectively). At the most recent examination, the mean best spectacle-corrected visual acuity (BSCVA) was 20/28 for the PKP group and 20/29 for the DALK group (P = 0.77). The percentage of eyes that achieved BSCVA of 20/25 or better was higher in the PKP group thaninthe DALK group (77.3 vs. 45.5%, respectively), but this difference was not statistically significant (P = 0.72). Endothelial rejection occurred in 4 (13.3%) eyes after PKP. Visually significant interface haze occurredin the early postoperative course in 2 (18.2%) eyes after DALK. No cases of late-onset endothelial failure were found in either group. Conclusion: Treatment of KC with PKP or DALK is associated with similar visual outcomes, graft survival, and prevalence of sight-threatening complications. © Springer Science+Business Media B.V. 2010.

引用

页码：675 / 681

页数：6

共 26 条

[1]

Sugar A., Sugar J., Techniques in penetrating keratoplasty: A quarter century of development, Cornea, 19, pp. 603-610, (2000)

[2]

Price M.O., Thompson Jr. R.W., Price Jr. F.W., Risk factors for various causes of failure in initial corneal grafts, Archives of Ophthalmology, 121, 8, pp. 1087-1092, (2003)

[3]

Jonas J.B., Rank R.M., Budde W.M., Immunologic graft reactions after allogenic penetrating keratoplasty, American Journal of Ophthalmology, 133, 4, pp. 437-443, (2002)

[4]

Wagoner M.D., Ba-Abbad R., Al-Mohaimeed M., Et al., Postoperative complications after primary adult optical penetrating keratoplasty: Prevalence and impact on graft survival, Cornea, 28, pp. 385-394, (2009)

[5]

Wagoner M.D., Ba-Abbad R., Sutphin J.E., Et al., Corneal transplant survival after onset of severe endothelial rejection, Ophthalmology, 114, pp. 1630-1636, (2007)

[6]

Thompson Jr. R.W., Price M.O., Bowers P.J., Price Jr. F.W., Long-term graft survival after penetrating keratoplasty, Ophthalmology, 110, 7, pp. 1396-1402, (2003)

[7]

Pramanik S., Musch D.C., Sutphin J.E., Farjo A.A., Extended Long-term Outcomes of Penetrating Keratoplasty for Keratoconus, Ophthalmology, 113, 9, pp. 1633-1638, (2006)

[8]

Wagoner M.D., Gonnah E.S., Al-Towerki A.E., Outcome of primary adult penetrating keratoplasty in a Saudi Arabian population, Cornea, 28, pp. 882-890, (2009)

[9]

Wagoner M.D., Ba-Abbad R., Penetrating keratoplasty for keratoconus with and without vernal keratoconjunctivitis, Cornea, 28, pp. 14-18, (2009)

[10]

Price F.W., Price M.O., Adult keratoplasty: Has the prognosis improved in the last 25 years?, Int Ophthalmol, 28, pp. 141-146, (2008)

← 1 2 3 →