Comparison of complications and visual outcomes between big-bubble deep anterior lamellar keratoplasty and penetrating keratoplasty for fungal keratitis
Clin Exp Ophthalmol. 2021 May 25. doi: 10.1111/ceo.13951. Online ahead of print.
BACKGROUND: To compare the postoperative complications and visual outcomes of big-bubble deep anterior lamellar keratoplasty (BB-DALK) and penetrating keratoplasty (PK) for fungal keratitis (FK).
METHODS: This retrospective study included 94 cases of BB-DALK for FK and 161 cases of PK for FK from a tertiary ophthalmology care centre.
RESULTS: The most common FK pathogens were Fusarium (n = 84, 32.9%) and Aspergillus (n = 67, 26.3%). The recurrence rates after BB-DALK and PK were 3.2% and 5%, respectively (P = 0.723). The follow-up duration was 31.9 ± 15.8 months in the BB-DALK group and 33.9 ± 15.0 months in the PK group. The immune rejection rate was significantly lower in the BB-DALK group than in the PK group (1.1% vs. 18.6%, P < 0.001), as was the incidence of secondary glaucoma (P = 0.018). Endothelial cell density in the BB-DALK group tended to be stable at postoperative month 6, whereas the PK group still attenuated at a hyper-physiological rate. Postoperative best-corrected visual acuity (BCVA) significantly improved in both groups (P < 0.001). No significant difference between-group was observed in BCVA, refractive cylinder, and spherical equivalent postoperatively.
CONCLUSION: Big-bubble DALK is a useful and safe alternative to PK for medically uncontrolled FK. This article is protected by copyright. All rights reserved.