Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis

Hong The Nguyen,1,2 Ngoc Dong Pham,3 Tung Quoc Mai,2 Hang Thi Thuy Do,3 Duong Thi Nga Nguyen,3 Peter McCluskey,4 Trong Van Pham2 1Department of Ophthalmology, 108 Military Central Hospital, Hanoi, Vietnam; 2Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam; 3Department of Cornea,...

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Autores principales:	Nguyen HT, Pham ND, Mai TQ, Do HTT, Nguyen DTN, McCluskey P, Pham TV
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	deep anterior lamellar keratoplasty dalk descemetocele corneal perforation corneal transplantation Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c895afdfb37f44c4bd8d25aa4e6cb088
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spelling	oai:doaj.org-article:c895afdfb37f44c4bd8d25aa4e6cb0882021-12-02T18:01:04ZTectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis1177-5483https://doaj.org/article/c895afdfb37f44c4bd8d25aa4e6cb0882021-08-01T00:00:00Zhttps://www.dovepress.com/tectonic-deep-anterior-lamellar-keratoplasty-to-treat-corneal-perforat-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Hong The Nguyen,1,2 Ngoc Dong Pham,3 Tung Quoc Mai,2 Hang Thi Thuy Do,3 Duong Thi Nga Nguyen,3 Peter McCluskey,4 Trong Van Pham2 1Department of Ophthalmology, 108 Military Central Hospital, Hanoi, Vietnam; 2Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam; 3Department of Cornea, Vietnam National Eye Hospital, Hanoi, Vietnam; 4Department of Ophthalmology, University of Sydney, Sydney, NSW, AustraliaCorrespondence: Tung Quoc MaiDepartment of Ophthalmology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, 100000, VietnamTel +84 915644181Email maiquoctung@hmu.edu.vnPurpose: To evaluate the result of tectonic deep anterior lamellar keratoplasty (DALK) for keratitis with perforation and descemetocele.Patients and Methods: A prospective clinical study of 36 patients (36 eyes) treated with tectonic DALK for corneal perforation or descemetocele from microbial keratitis managed at the Vietnam National Eye Hospital over a two-year period. The surgical technique was manual lamellar dissection. The grafts were harvested from the anterior corneal cap of pre-cut donor tissues used for DSAEK or donor corneas with a low endothelial cell count.Results: A mean age was 55.36 ± 13.98 years (ranged from 25 to 75 years). Female gender represented 52%. causative agents were herpes simplex virus (58.3%), bacteria (22.2%), fungi (13.9%) and microsporidia (5.6%). There were 24 eyes with descemetocele (66.7%) and 12 with perforation (33.3%). There were 33 successful cases (91.7%) and 3 failed cases (8.3%). Best corrected visual acuity (BCVA) improved in 28 eyes (84.8%). The range of post-operative BCVA was from hand motions to 20/70. Eleven eyes (33.3%) attained vision 20/200 and higher. Clear graft was obtained in 15 eyes (45.5%), while mild or severe graft opacity was observed in 14 eyes (42.4%), and 4 eyes (12.1%), respectively. Surgical complications included descemet rupture (20.8%), pseudo anterior chamber (41.6%), persistent corneal epithelial defects (8.3%), reinfection (11.1%), glaucoma or ocular hypertension (5.6%) and cataract (8.3%).Conclusion: The study demonstrates that DALK is an effective procedure to treat corneal descemetocele, especially when an urgent penetrating keratoplasty (PKP) cannot be performed.Keywords: deep anterior lamellar keratoplasty, DALK, descemetocele, corneal perforation, corneal transplantationNguyen HTPham NDMai TQDo HTTNguyen DTNMcCluskey PPham TVDove Medical Pressarticledeep anterior lamellar keratoplastydalkdescemetocelecorneal perforationcorneal transplantationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 3549-3555 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	deep anterior lamellar keratoplasty dalk descemetocele corneal perforation corneal transplantation Ophthalmology RE1-994
spellingShingle	deep anterior lamellar keratoplasty dalk descemetocele corneal perforation corneal transplantation Ophthalmology RE1-994 Nguyen HT Pham ND Mai TQ Do HTT Nguyen DTN McCluskey P Pham TV Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis
description	Hong The Nguyen,1,2 Ngoc Dong Pham,3 Tung Quoc Mai,2 Hang Thi Thuy Do,3 Duong Thi Nga Nguyen,3 Peter McCluskey,4 Trong Van Pham2 1Department of Ophthalmology, 108 Military Central Hospital, Hanoi, Vietnam; 2Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam; 3Department of Cornea, Vietnam National Eye Hospital, Hanoi, Vietnam; 4Department of Ophthalmology, University of Sydney, Sydney, NSW, AustraliaCorrespondence: Tung Quoc MaiDepartment of Ophthalmology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, 100000, VietnamTel +84 915644181Email maiquoctung@hmu.edu.vnPurpose: To evaluate the result of tectonic deep anterior lamellar keratoplasty (DALK) for keratitis with perforation and descemetocele.Patients and Methods: A prospective clinical study of 36 patients (36 eyes) treated with tectonic DALK for corneal perforation or descemetocele from microbial keratitis managed at the Vietnam National Eye Hospital over a two-year period. The surgical technique was manual lamellar dissection. The grafts were harvested from the anterior corneal cap of pre-cut donor tissues used for DSAEK or donor corneas with a low endothelial cell count.Results: A mean age was 55.36 ± 13.98 years (ranged from 25 to 75 years). Female gender represented 52%. causative agents were herpes simplex virus (58.3%), bacteria (22.2%), fungi (13.9%) and microsporidia (5.6%). There were 24 eyes with descemetocele (66.7%) and 12 with perforation (33.3%). There were 33 successful cases (91.7%) and 3 failed cases (8.3%). Best corrected visual acuity (BCVA) improved in 28 eyes (84.8%). The range of post-operative BCVA was from hand motions to 20/70. Eleven eyes (33.3%) attained vision 20/200 and higher. Clear graft was obtained in 15 eyes (45.5%), while mild or severe graft opacity was observed in 14 eyes (42.4%), and 4 eyes (12.1%), respectively. Surgical complications included descemet rupture (20.8%), pseudo anterior chamber (41.6%), persistent corneal epithelial defects (8.3%), reinfection (11.1%), glaucoma or ocular hypertension (5.6%) and cataract (8.3%).Conclusion: The study demonstrates that DALK is an effective procedure to treat corneal descemetocele, especially when an urgent penetrating keratoplasty (PKP) cannot be performed.Keywords: deep anterior lamellar keratoplasty, DALK, descemetocele, corneal perforation, corneal transplantation
format	article
author	Nguyen HT Pham ND Mai TQ Do HTT Nguyen DTN McCluskey P Pham TV
author_facet	Nguyen HT Pham ND Mai TQ Do HTT Nguyen DTN McCluskey P Pham TV
author_sort	Nguyen HT
title	Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis
title_short	Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis
title_full	Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis
title_fullStr	Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis
title_full_unstemmed	Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis
title_sort	tectonic deep anterior lamellar keratoplasty to treat corneal perforation and descemetocele from microbial keratitis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/c895afdfb37f44c4bd8d25aa4e6cb088
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Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis

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