Abstract:

BACKGROUND: Deep lamellar keratoplasty for the treatment of keratoconus can improve the visual acuity significantly with less complications and low rejection rate, but the treatment of scarring stage keratoconus is mainly depends on the partial penetrating keratoplasty.
OBJECTIVE: To evaluate the clinical efficacy of deep lamellar keratoplasty for the treatment of scarring stage keratoconus.
METHODS: Fifty-eight patients with Ⅲ and Ⅳ scarring stage keratoconus were divided into two groups: patients with corneal scarring in the superficial corneal stroma (n=37, superficial scar group), patients with corneal scarring in the deep or whole corneal stroma (n=21, deep scar group). The 58 patients who had accepted deep lamellar keratoplasy were followed-up for 12 months and the changes of visual acuity before and after transplantation were compared.
RESULTS AND CONCLUSION: Naked eye vision of all patients with deep lamellar keratoplasy was significantly improved compared with that before transplantation, and 58 corneal grafts were all transparent. Only one patient had epithelial rejection after 2 months postoperative, and the corneal graft became transparent after a drug treatment. Two patients with deep keratoconus scars experienced glare after the transplantation in deep scar group, and they were switched to partial penetrating keratoplasty treatment. There was no significant difference of visual acuity at 1 year after transplantation between superficial scar group and deep scar group. Deep lamellar corneal keratoplasty treatments can significantly improve the visual acuity of scarring stage keratoconus patients, while it is low in rejection rate with less complication. It is a safe, effective and feasible treatment method, especially for the treatment of large base keratoconus.

Key words: organ transplantation, tissue transplantation, keratoconus, scar stage, deep lamellar transplantation, corneal transplantation, corneal scar formation, vision, complications, cataract, amblyopia, glaucoma, other grants-supported paper, photographs-containing paper of organ transplantation