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. 2021 Aug;49(6):550-559.
doi: 10.1111/ceo.13951. Epub 2021 Jun 8.

Comparison of complications and visual outcomes between big-bubble deep anterior lamellar keratoplasty and penetrating keratoplasty for fungal keratitis

Xiunian Chen  1   2 , Xiaofeng Li  2   3 , Xiaoyu Zhang  2   3 , Xiaoting Guo  2 , Xiaolin Qi  2   3 , Suxia Li  2   3 , Weiyun Shi  2   3 , Hua Gao  1   2   3
Affiliations

Comparison of complications and visual outcomes between big-bubble deep anterior lamellar keratoplasty and penetrating keratoplasty for fungal keratitis

Xiunian Chen et al. Clin Exp Ophthalmol. 2021 Aug.

Abstract

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.

Keywords: big-bubble deep anterior lamellar keratoplasty; fungal keratitis; penetrating keratoplasty.

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References

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