Deep Anterior Lamellar Keratoplasty in Keratoconic Patients with versus without Vernal Keratoconjunctivitis

• Published in: Journal of ophthalmic & vision research Vol. 10; no. 2; pp. 112 - 117
• Main Authors: Feizi, Sepehr, Javadi, Mohammad Ali, Javadi, Fatemeh, Jafarinasab, Mohammad Reza
• Format: Journal Article
• Language: English
• Published: Iran Medknow Publications and Media Pvt. Ltd 01.04.2015; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Knowledge E
• Subjects: Cataracts; Comparative analysis; Conflicts of interest; Conjunctivitis; Corneal transplantation; Deep Anterior Lamellar Keratoplasty; Graft Survival; Keratoconus; Vernal Keratoconjunctivitis; Inflammation; Keratoconus; Medical prognosis; Medical research; Original; Patient outcomes; Precision medicine; Steroids; Surgery; Surgical techniques; Topography; Transplants & implants; Graft Survival; Vernal Keratoconjunctivitis; Deep Anterior Lamellar Keratoplasty; Keratoconus
• ISSN: 2008-2010; 2008-322X; 2008-322X
• DOI: 10.4103/2008-322X.163768

To compare the clinical outcomes of deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC) versus those without VKC. In this retrospective comparative study, records of 262 eyes with keratoconus (Group 1) and 28 keratoconic eyes with VKC (Group 2) that had undergone DALK were compiled. Reviewed parameters included length of follow-up, best-corrected visual acuity (BCVA), refractive error, complications and cumulative graft survival. Mean duration of follow-up was 38.6 ± 20.2 and 34.4 ± 20.9 months in groups 1 and 2, respectively (P = 0.21). Mean post-operative BCVA was 0.19 ± 0.11 and 0.20 ± 0.15 logMAR, in groups 1 and 2 (P = 0.79). BCVA≥20/40 was achieved in 91.6 and 88.5% of eyes in groups 1 and 2, respectively (P = 0.48). Epithelial problems were encountered in 31.3 and 42.9% of operated eyes, respectively (P = 0.16). Vascularization of suture tracts and stitch abscesses were encountered more frequently in the eyes with VKC (P = 0.01 and <0.001, respectively). At the 33-month follow-up examination, rejection-free graft survival rates were 56.0% in group 1 and 33.3% in group 2, with mean durations of 41.0 and 32.1 months, respectively (P = 0.15). Graft survival rates were 98.1% in group 1 and 95.0% in group 2, with mean durations of 88.6 and 88.4 months, respectively (P = 0.74). Clinical outcomes of DALK in keratoconic eyes with VKC were comparable to those in eyes with keratoconus alone. However, complications such as suture tract vascularization and stitch abscesses were more common when VKC coexisted, necessitating closer monitoring.