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Comparison of deep lamellar keratoplasty and penetrating keratoplasty for lattice and macular corneal dystrophies.
Am J Ophthalmol 2006; 142(2):304-9AJ

Abstract

PURPOSE

To compare the therapeutic outcomes after deep lamellar keratoplasty (DLKP) and penetrating keratoplasty (PKP) in patients with lattice corneal dystrophy (LCD) and macular corneal dystrophy (MCD).

DESIGN

Age-matched control study.

METHODS

We reviewed the clinical records of 84 eyes with LCD or MCD who had DLKP (41 eyes) or PKP (43 eyes). Primary pathology consisted of 60 eyes with LCD and 24 eyes with MCD. DLKP was performed by either removing stromal tissue gradually, or by viscodissection of Descemet's membrane. Graft clarity, best-corrected visual acuity (BCVA), endothelial density, and complications were compared between DLKP and PKP, as well as between LCD and MCD.

RESULTS

All 84 eyes showed a postoperative improvement in visual acuity. The median final BCVA was not significantly different between PKP and DLKP groups. Endothelial cell loss rates were similar for DLKP and PKP. While the MCD-DLKP group showed progressive decrease in endothelial density, this was not observed in the LCD-DLKP group after surgery. In the DLKP group, most of the complications occurred intraoperatively or in the early phase, whereas late phase complications such as endothelial rejection and secondary glaucoma were the main complications in the PKP group.

CONCLUSIONS

PKP is no longer an automatic choice for the surgical treatment for LCD and MCD; DLKP seems to be a safe alternative. While DLKP is a favorable method for LCD, MCD may not be a good candidate, as it might show progressive decrease in the corneal endothelium postoperatively.

Authors+Show Affiliations

Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. motokok@tdc.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16876513

Citation

Kawashima, Motoko, et al. "Comparison of Deep Lamellar Keratoplasty and Penetrating Keratoplasty for Lattice and Macular Corneal Dystrophies." American Journal of Ophthalmology, vol. 142, no. 2, 2006, pp. 304-9.
Kawashima M, Kawakita T, Den S, et al. Comparison of deep lamellar keratoplasty and penetrating keratoplasty for lattice and macular corneal dystrophies. Am J Ophthalmol. 2006;142(2):304-9.
Kawashima, M., Kawakita, T., Den, S., Shimmura, S., Tsubota, K., & Shimazaki, J. (2006). Comparison of deep lamellar keratoplasty and penetrating keratoplasty for lattice and macular corneal dystrophies. American Journal of Ophthalmology, 142(2), pp. 304-9.
Kawashima M, et al. Comparison of Deep Lamellar Keratoplasty and Penetrating Keratoplasty for Lattice and Macular Corneal Dystrophies. Am J Ophthalmol. 2006;142(2):304-9. PubMed PMID: 16876513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of deep lamellar keratoplasty and penetrating keratoplasty for lattice and macular corneal dystrophies. AU - Kawashima,Motoko, AU - Kawakita,Tetsuya, AU - Den,Seika, AU - Shimmura,Shigeto, AU - Tsubota,Kazuo, AU - Shimazaki,Jun, PY - 2005/08/10/received PY - 2006/03/24/revised PY - 2006/03/24/accepted PY - 2006/8/1/pubmed PY - 2006/8/30/medline PY - 2006/8/1/entrez SP - 304 EP - 9 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 142 IS - 2 N2 - PURPOSE: To compare the therapeutic outcomes after deep lamellar keratoplasty (DLKP) and penetrating keratoplasty (PKP) in patients with lattice corneal dystrophy (LCD) and macular corneal dystrophy (MCD). DESIGN: Age-matched control study. METHODS: We reviewed the clinical records of 84 eyes with LCD or MCD who had DLKP (41 eyes) or PKP (43 eyes). Primary pathology consisted of 60 eyes with LCD and 24 eyes with MCD. DLKP was performed by either removing stromal tissue gradually, or by viscodissection of Descemet's membrane. Graft clarity, best-corrected visual acuity (BCVA), endothelial density, and complications were compared between DLKP and PKP, as well as between LCD and MCD. RESULTS: All 84 eyes showed a postoperative improvement in visual acuity. The median final BCVA was not significantly different between PKP and DLKP groups. Endothelial cell loss rates were similar for DLKP and PKP. While the MCD-DLKP group showed progressive decrease in endothelial density, this was not observed in the LCD-DLKP group after surgery. In the DLKP group, most of the complications occurred intraoperatively or in the early phase, whereas late phase complications such as endothelial rejection and secondary glaucoma were the main complications in the PKP group. CONCLUSIONS: PKP is no longer an automatic choice for the surgical treatment for LCD and MCD; DLKP seems to be a safe alternative. While DLKP is a favorable method for LCD, MCD may not be a good candidate, as it might show progressive decrease in the corneal endothelium postoperatively. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/16876513/Comparison_of_deep_lamellar_keratoplasty_and_penetrating_keratoplasty_for_lattice_and_macular_corneal_dystrophies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(06)00441-7 DB - PRIME DP - Unbound Medicine ER -