EVALUATION OF DEEP ANTERIOR LAMELLAR KERATOPLASTY VERSUS INTRACORNEAL RING SEGMENTS IN TREATING MODERATE KERATOCONUS
Mohammed Alsaied Alnaimy*, Abdelmonem Alsyed Abou-sharkh, Mahmoud Nasr Al-deeb and Ayman Mohammed Abdelrahman
Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
*Corresponding author: Mohammed Alsaied Alnaimy, Mobile: 01226043131 E mail:moh_alnaimy@hotmail.com
ABSTRACT
Background: Keratoconus can cause gradual distortion of vision due to progressive myopia and irregular astigmatism. keratoconus is classified into four stages. The treatment is stage specific starting from glasses or hard contact lenses in the very early stages passing to intra corneal …show more content…
causing gradual distortion of vision due to progressive myopia and irregular astigmatism and typically diagnosed in the patient's adolescent years [1]. Because surgical treatment of keratoconus is stage specific [2], there are many classifications that have been developed for tracking disease severity in keratoconus. keratoconus according to modified Amsler Krumuch has four grades. Keratoconus suspect there is eccentric steepening, Myopia, induced astigmatism, or both -5.00D, Mean central K readings 48.00 D, mild keratoconus there is myopia, induced astigmatism, or both from -5.00 to -6.00 D, Mean central K reading 51.00 D, Absence of scarring, minimum corneal thickness 400 micron, moderate keratoconus :Myopia, induced astigmatism, or both from- 6.00 to -10.00 D, Mean central K readings 53.00 D, Absence of scarring, minimum corneal thickness 300 to 400micron and in severe keratoconus, Refraction not measurable, mean central K readings 55.00 D, Central corneal scarring, Minimum corneal thickness 200 micron …show more content…
In a DALK graft, only the outermost epithelium and about 80 % of corneal stroma are replaced; the patient's rearmost endothelium layer and the Descemet's membrane are left, giving some additional structural integrity to the transplanted cornea [9]. Comparisons indicate that outcomes are similar to penetrating keratoplasty in terms of visual acuity and astigmatism, with about 80% of patients achieving a best-corrected visual acuity of 20/40 or greater in most series [10]. Technology assessment by the American Academy of Ophthalmology concluded that DALK is equivalent to penetrating keratoplasty in terms of refractive error, and is superior for preservation of endothelial cell density. They believe that wherever feasible, DALK should be performed as the standard of care surgery when keratoplasty is required in keratoconus
Mohammed Alsaied Alnaimy*, Abdelmonem Alsyed Abou-sharkh, Mahmoud Nasr Al-deeb and Ayman Mohammed Abdelrahman
Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
*Corresponding author: Mohammed Alsaied Alnaimy, Mobile: 01226043131 E mail:moh_alnaimy@hotmail.com
ABSTRACT
Background: Keratoconus can cause gradual distortion of vision due to progressive myopia and irregular astigmatism. keratoconus is classified into four stages. The treatment is stage specific starting from glasses or hard contact lenses in the very early stages passing to intra corneal …show more content…
causing gradual distortion of vision due to progressive myopia and irregular astigmatism and typically diagnosed in the patient's adolescent years [1]. Because surgical treatment of keratoconus is stage specific [2], there are many classifications that have been developed for tracking disease severity in keratoconus. keratoconus according to modified Amsler Krumuch has four grades. Keratoconus suspect there is eccentric steepening, Myopia, induced astigmatism, or both -5.00D, Mean central K readings 48.00 D, mild keratoconus there is myopia, induced astigmatism, or both from -5.00 to -6.00 D, Mean central K reading 51.00 D, Absence of scarring, minimum corneal thickness 400 micron, moderate keratoconus :Myopia, induced astigmatism, or both from- 6.00 to -10.00 D, Mean central K readings 53.00 D, Absence of scarring, minimum corneal thickness 300 to 400micron and in severe keratoconus, Refraction not measurable, mean central K readings 55.00 D, Central corneal scarring, Minimum corneal thickness 200 micron …show more content…
In a DALK graft, only the outermost epithelium and about 80 % of corneal stroma are replaced; the patient's rearmost endothelium layer and the Descemet's membrane are left, giving some additional structural integrity to the transplanted cornea [9]. Comparisons indicate that outcomes are similar to penetrating keratoplasty in terms of visual acuity and astigmatism, with about 80% of patients achieving a best-corrected visual acuity of 20/40 or greater in most series [10]. Technology assessment by the American Academy of Ophthalmology concluded that DALK is equivalent to penetrating keratoplasty in terms of refractive error, and is superior for preservation of endothelial cell density. They believe that wherever feasible, DALK should be performed as the standard of care surgery when keratoplasty is required in keratoconus