Personalized surgeries restore corneal clarity following DALK complications
A new study found that various surgical techniques can successfully improve visual acuity and restore corneal clarity in patients with stromal interface irregularities following deep anterior lamellar keratoplasty (DALK). The study noted that the choice of technique should be tailored to the individual patient’s needs to optimize outcomes while maintaining the benefits of minimally invasive procedures.
The explored various surgical approaches to address stromal interface irregularities following DALK, a procedure often used to treat corneal disorders while preserving the endothelium. This interventional case series involved patients requiring repeat keratoplasty due to stromal opacity or irregularity post-DALK.
The study evaluated 5 surgical techniques aimed at restoring corneal clarity and improving visual acuity: simple anterior lamellar graft exchange, repeat DALK with pneumatic dissection, repeat DALK with deepening of manual dissection, central stromal-endothelium-Descemet complex replacement, and 2-piece microkeratome-assisted mushroom penetrating keratoplasty.
The findings were promising, with all patients achieving significant improvements in visual acuity, some reaching 20/20 vision, and restored corneal clarity. Importantly, there were no reported intraoperative or postoperative complications, and no recurrence of the underlying disease was observed.
The study concluded that the choice of surgical technique should be tailored to each patient’s specific condition to maximize the benefits of minimally invasive grafts while effectively managing stromal interface irregularities.
Reference
Lucisano A, Mancini A, Taloni A, et al. Surgical Strategies to Manage Stromal Interface Irregularity Following Deep Anterior Lamellar Keratoplasty. Cornea. 2024;doi: 10.1097/ICO.0000000000003668. Epub ahead of print. PMID: 39177403.
