Pneumatic Dissection Through Modified Deep Anterior Lamellar Keratoplasty In Post-Radial Keratotomy Eyes

Published 2022 - 40th Congress of the ESCRS

Reference: PP14.07 | Type: Free paper | DOI: 10.82333/36e5-p558

Authors: Tommaso Bocca* ¹ , Angeli Christy Yu ¹ , Niccolò Salgari ¹ , Luca Furiosi ¹ , Rossella Spena ¹ , Massimo Busin ¹

¹Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy

Purpose

To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) in eyes that previously underwent radial keratoplasty (RK)

Setting

Tertiary Eye Care Referral Center (Ospedali Privati Forlì “Villa Igea”, Forlì, Italy)

Methods

This was a prospective interventional case series evaluating consecutive post-RK eyes that underwent 9-mm DALK. Main outcome measures were best spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA), and complication rates.

Results

This series included 5 eyes from 5 patients with a mean age at surgery of 63±7 (range: 56 to 71) years and mean interval from RK of 27±2 (range:24-30) years. Pneumatic dissection succeeded in 4 of 5 cases. Type 1 bubble was obtained in 3 eyes while type 2 bubble was obtained in 1 case. In all eyes, best spectacle-corrected visual acuity was ≥20/50 and refractive astigmatism was less than 2.5 diopters. No episode of double anterior chamber formation, immunologic rejection nor other postoperative complications were observed.

Conclusions

It is reasonable to attempt DALK using pneumatic dissection in post-RK eyes. In order to succeed in big bubble formation, corneal surgeons may consider employing modifications in the conventional DALK technique, including deep trephination based on AS-OCT thinnest point pachymetry at 9mm, subsequent cannular insertion at the base of deep trephination directly at the proper depth, and minimal centripetal advancement.