Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (18): 3272-3276.doi: 10.3969/j.issn.1673-8225.2012.18.010

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Refraction change and influential factors of keratoconus after modified deep lamellar keratoplasty*★

Zhang Mei-ai1, Gao Hua2, Li Su-xia2, Wang Xiu-xian2, Sun Guang-hua1, Shi Wei-yun2   

  1. 1Qingdao University, Qingdao  266071, Shandong Province, China; 2Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan  250021, Shandong Province, China
  • Received:2012-01-23 Revised:2012-02-15 Online:2012-04-29 Published:2012-04-29
  • Contact: Shi Wei-yun, Chief physician, Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250021, Shandong Province, China weiyunshi@163.com
  • About author:Zhang Mei-ai★, Studying for master’s degree, Physician, Qingdao University, Qingdao 266071, Shandong Province, China zyqiuqiu1234@163.com
  • Supported by:

    Natural Science Foundation of Shandong Province (General Program), No. ZR211HM015*

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Abstract:

BACKGROUND: Traditional deep lamellar keratoplasty in keratoconus treatment shows a high perforation of Descemet’s membrane.
OBJECTIVE: To study the long-term results of modified deep lamellar keratoplasty (DLKP) for the treatment of keratoconus, and analyze related factors.
METHODS: A total of 46 patients (51 eyes) with keratoconus received modified DLKP. The uncorrected visual acuity and best corrected visual acuity were recorded before and after surgery; according to preoperative mean corneal curvature, all patients were divided into two groups, one group is ≥ 60 m-1 (38 eyes) and the other group is < 60 m-1 (13 eyes). Spherical equivalent, astigmatism and mean corneal curvature were recorded between the two groups within 2 years postoperatively, and the correlation between postoperative refractive state and eye axis was analyzed.
RESULTS AND CONCLUSION: The uncorrected visual acuity and best corrected visual acuity at postoperative 1, 6, 12, 18, 24 months were significantly improved compared with before surgery (P < 0.01 or 0.05). The visual acuity was improved significantly within 6 months after the surgery, then maintained stable and improved slightly from 6 months to 18 months after the surgery, and improved significantly from 18 months to 24 months after the surgery. These results showed that the visual acuity improved and trended to be stable with the extension of postoperative time, which indicated that the long-term results of modified DLKP for the treatment of keratoconus was much better. The spherical equivalent, astigmatism and mean corneal curvature of the two groups were all improved within 2 years postoperatively, but there was no statistical difference between the two groups (P > 0.05). There was a negative correlation between eye axis and the spherical equivalent, astigmatism, mean corneal curvature within 24 months after the surgery (r=-0.30, r=-0.29, r=-0.61). The spherical equivalent and mean corneal curvature increased gradually while the corneal astigmatism decreased gradually after DLKP, there was no obvious influence of the mean corneal curvature on the refractive state after DLKP, while eye axis was related.

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