EFFECTIVENESS OF THERAPEUTIC DEEP ANTERIOR LAMELLAR KERATOPLASTY VS PENETRATING KERATOPLASTY FOR CORNEAL PATHOLOGY

Objective. To develop a method of therapeutic deep anterior lamellar keratoplasty (DALK) for corneal defects of various etiologies and to study the effectiveness of this operation in comparison with therapeutic penetrating keratoplasty (PKP).

Materials and methods. 92 patients (94 eyes) suffering from severe corneal ulcers, eye burns, corneal hydrops or advanced corneal ectasias were included in the study. Therapeutic PKP was performed in 45 patients (47 eyes, Group 1) in Minsk City Hospital in 2014 to 2020. Therapeutic DALK was done using the “big bubble” technique or the modified technique in 46 patients (47 eyes, Group 2).

Results. Immune corneal ulcers were revealed in 18.1% of cases, neurotrophic ulcers in 14.8%, viral ulcers in 12.8%, corneal ectasia or hydrops in18.1%, burn ulcers in 11.7%. Persistent epithelial defects of corneal transplants were observed postoperatively in 19.2% of cases in Group 1, in 14.9% in Group 2. The anatomical result was achieved in 89.4% of cases in Group 1, in 95.7% in Group 2 (p <0.05). The rekeratoplasty rate was higher in Group 1 (19.1%) being 6.4% in Group 2 (p£0.05). Graft was rejected in 48.9% of cases in Group 1 and in 19.1% of cases in Group 2. Functional results were obtained in 34% of cases in Group 1 and in 40.4% of cases in Group 2.

Conclusion. The high effectiveness of the therapeutic DALK and the significantly lower rate of postoperative complications allow use the operation as an alternative to the PKP.

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Автор(ы): H. V. Sitnik