Prognosis of deep lamellar keratoplasty versus penetrating keratoplasty in the treatment of stromal corneal dystrophy

doi:10.12307/2025.347

Abstract

Abstract: BACKGROUND: The traditional surgical treatment for stromal corneal dystrophy is penetrating keratoplasty. In recent years, more and more doctors are considering using deep lamellar keratoplasty to treat stromal corneal dystrophy. Few studies comparing penetrating keratoplasty and deep lamellar keratoplasty for stromal corneal dystrophy have been reported in China.
OBJECTIVE: To compare the clinical efficacy of deep lamellar keratoplasty and penetrating keratoplasty in the treatment of stromal corneal dystrophy.
METHODS: Fifty-seven patients (57 eyes) diagnosed with stromal corneal dystrophy and admitted at the General Hospital of Northern Theater Command from January 2000 to January 2018 were selected, including 18 males and 39 females, aged (52.9±20.0) years. They were divided into two groups based on the surgical procedure: 21 cases (21 eyes) in the deep lamellar keratoplasty group and 36 cases (36 eyes) in the penetrating keratoplasty group. A 12-month follow-up was conducted to observe the best-corrected visual acuity, corneal endothelial cell density, corneal graft transparency, intraoperative and postoperative complications, and recurrence of the original disease.

RESULTS AND CONCLUSION: Visual acuity at 1, 3, 6, and 12 months postoperatively was higher than preoperatively in both groups (P < 0.05). The postoperative best-corrected visual acuity between the two groups showed no significant difference (P > 0.05). With the prolongation of postoperative time, the corneal endothelial cell density gradually decreased in the two groups, and the annual loss rate of corneal endothelial cell density in the penetrating keratoplasty group was higher than that of the deep lamellar keratoplasty group at 6 and 12 months postoperatively (P < 0.05), while there was no significant difference in corneal graft transparency between the two groups at 12 months postoperatively (P > 0.05). There were six cases of complications in the deep lamellar keratoplasty group and 14 cases of complications in the penetrating keratoplasty group. There was no recurrence in 57 cases within 12 months after surgery, and the difference in recurrence rates between the two groups at 5 years after surgery was not significant (P > 0.05). The graft survival rates at 5 years after surgery in the penetrating keratoplasty group and the deep lamellar keratoplasty group were 83% and 86%, respectively, and there was no significant difference between the two groups (P > 0.05). To conclude, deep lamellar keratoplasty could be considered as an alternative to penetrating keratoplasty in the treatment of stromal corneal dystrophy.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: penetrating keratoplasty, deep lamellar keratoplasty, stromal corneal dystrophy, best-corrected visual acuity, corneal graft transparency, corneal endothelial cell density, complication, recurrence

CLC Number:

Jing Ruyi, Chen Yingxin, Cao Lei . Prognosis of deep lamellar keratoplasty versus penetrating keratoplasty in the treatment of stromal corneal dystrophy[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(8): 1626-1633.

Figures/Tables 11

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