ISSN: 1859 - 2872
Deep anterior lamellar keratoplasty to treat corneal perforation and descemetocele from microbial keratitis
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Abstract
Objective: To evaluate the result of tectonic deep anterior lamellar keratoplasty (DALK) for microbial keratitis. Subject and method: A prospective observational study of 43 patients (43 eyes) treated with DALK for microbial keratitis managed at the Vietnam National Eye Hospital from January 2018 to March 2020. Result: Causative agents were virus Herpes simplex (55.8%), bacteria (25.6%), fungi (14.0%) and microsporidia (4.7%). There were 30 descemetocele eyes (69.8%) and 13 perforated eyes (30.2%). There were 40 successful cases (93.0%) and 3 failed cases (7.0%) at the one-year follow-up. The mean postoperative best corrected visual acuity (BCVA) (LogMAR) was 1.26 ± 0.50 that improved compared to the mean preoperative BCVA (LogMAR) was 1.99 ± 0.52 (p<0.05). Clear graft was obtained in 19 eyes (47.5%), while mild or severe graft opacity were observed in 14 eyes (35.0%), and 7 eyes (17.5%), respectively. Surgical complications included Descemet rupture (16.7%), pseudo anterior chamber (34.9%), persistent corneal epithelial defects (11.6%), reinfection (9.3%), glaucoma or ocular hypertension (5.0%) and cataract (7.5%). There was not any eye which had rejection in the one-year follow-up. Conclusion: The study demonstrates that DALK is an effective procedure to treat microbial keratitis, especially when an urgent penetrating keratoplasty (PKP) cannot be performed.
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References
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