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CLC number: R779.65

On-line Access: 2013-05-04

Received: 2012-10-11

Revision Accepted: 2012-12-20

Crosschecked: 2013-04-15

Cited: 24

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Journal of Zhejiang University SCIENCE B 2013 Vol.14 No.5 P.438-450


Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus

Author(s):  Yong-ming Zhang, Shuang-qing Wu, Yu-feng Yao

Affiliation(s):  Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; more

Corresponding email(s):   yaoyuf@mail.hz.zj.cn

Key Words:  Full-bed deep anterior lamellar keratoplasty, Penetrating keratoplasty, Keratoconus, Forceps hooking, Viscoelastic detaching

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Yong-ming Zhang, Shuang-qing Wu, Yu-feng Yao. Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus[J]. Journal of Zhejiang University Science B, 2013, 14(5): 438-450.

@article{title="Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus",
author="Yong-ming Zhang, Shuang-qing Wu, Yu-feng Yao",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus
%A Yong-ming Zhang
%A Shuang-qing Wu
%A Yu-feng Yao
%J Journal of Zhejiang University SCIENCE B
%V 14
%N 5
%P 438-450
%@ 1673-1581
%D 2013
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1200272

T1 - Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus
A1 - Yong-ming Zhang
A1 - Shuang-qing Wu
A1 - Yu-feng Yao
J0 - Journal of Zhejiang University Science B
VL - 14
IS - 5
SP - 438
EP - 450
%@ 1673-1581
Y1 - 2013
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1200272

Objective: To compare postoperative outcomes of full-bed deep anterior lamellar keratoplasty (DALK) with penetrating keratoplasty (PK) in treating keratoconus. Methods: Seventy-five eyes of 64 patients who received full-bed DALK and 52 eyes of 51 patients who received PK between June 2000 and August 2010 were included in this retrospective study. Full-bed DALK was performed using Yao’s hooking-detaching technique. PK was performed using a standard technique. Intraoperative and postoperative complications, visual acuity, rejection, graft survival, endothelial cell density, corneal sensation recovery, and re-innervation were compared between the two groups. Results: A best correct visual acuity of 0.5 or better was achieved in 90.7% of eyes after full-bed DALK and in 92.3% of eyes after PK (P=0.75). By the fifth postoperative year, graft endothelial cell loss reached 34.6% in the PK group vs. 13.9% in the full-bed DALK group (P<0.001). There were no statistical differences in corneal sensitivity recovery or corneal re-innervation between the groups (P>0.05). Intraoperative microperforation occurred in seven out of 75 (9.3%) eyes with a temporally postoperative double anterior chamber in two eyes in the full-bed DALK group. Postoperative complications in the PK vs. the full-bed DALK groups respectively were: rejection (7.7% vs. 0%, P=0.015), high intraocular pressure (IOP) (46.2% vs. 1.3%, P<0.001), secondary glaucoma (9.6% vs. 0%, P=0.006), complicated cataract (19.2% vs. 0%, P<0.001), and wound dehiscence (9.6% vs. 0%, P=0.006). Conclusions: Both full-bed DALK and PK can offer long-term satisfactory visual outcomes for keratoconus. Graft rejection, secondary glaucoma, complicated cataracts, and constant endothelial cell loss were observed in eyes only after PK.

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