%0 Journal Article
%T Deep Anterior Lamellar Keratoplasty Using the Big-Bubble Technique in Keratoconus
%A Mohammad-Ali Javadi
%A Sepehr Feizi
%A Hossein Jamali
%A Firooz Mirbabaee
%J Journal of Ophthalmic & Vision Research
%D 2009
%I Ophthalmic Research Center
%X PURPOSE: To evaluate the visual outcomes and complications of deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in patients with keratoconus. METHODS: In this case series, 104 eyes of 99 patients with moderate to advanced keratoconus underwent DALK. All subjects were contact lens intolerant or had unacceptable spectacle-corrected visual acuity. DALK was performed using the big-bubble technique. Full thickness donor corneas devoid of Descemet's membrane (DM) were sutured to the recipient bed. Best spectacle-corrected visual acuity (BSCVA), refractive status, and intra- and postoperative complications were evaluated. RESULTS: Patients were male in 62.5%. Mean age of patients was 26.2¡À7.79 (range 15-46) years at the time of DALK and were followed for 23.07¡À8.1 (range 9-42) months. Mean BSCVA increased from 1.23¡À0.4 logMAR to 0.26¡À0.2 logMAR at final follow-up (P < 0.001). Postoperative mean spherical equivalent refractive error and refractive and keratometric astigmatism were -3.41¡À3.1 D, 3.07¡À2.4 D, and 3.64¡À2.2 D, respectively. Bared DM was achieved in 86 (82.7%) eyes. Main complications encountered included filamentary keratitis (19.2%), non-endothelial graft rejection (14.4%), and suture abscess (10.6%). CONCLUSIONS: DALK using the big-bubble technique appears to be a safe and effective procedure in patients with keratoconus.
%U http://www.jovr.ir/index.php/jovr/article/view/78