[Deep anterior lamellar keratoplasty evaluation in patients with keratoconus].

PURPOSE: To evaluate the efficacy, complications and confocal microscopy corneal features of deep anterior lamellar keratoplasty using the air dissection technique in keratoconus.

METHODS

Seventeen eyes with advanced keratoconus were submitted to this technique. Postoperative visual acuity and complication rate were analyzed. The thicknesses of full cornea tissue, host bed and donor button were measured, donor-host interface was also evaluated using confocal microscopy.

RESULTS

Best-spectacle corrected visual acuity was 0.5 or better in 50% of the eyes. Complications occurred in five of seventeen patients (29.41%). Confocal microscopy demonstrated in four eyes the presence of hyperreflective structures at the interface, suggesting deposits and striae. Average corneal pachymetry, donor button and host bed thicknesses were respectively 609.00+/-77.55 microm, 516.55+/-43.65 microm and 92.50+/-60.10 microm.

CONCLUSIONS

Although technically challenging with the risk of intraoperative Descemet's membrane perforation, deep anterior lamellar keratoplasty with air dissection technique presents as an option for keratoconus treatment. Confocal microscopy demonstrated to be a useful method not only for the pachymetry measurement but also for the evaluation of interface by observing the absence of opacities in most of the cases.