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| |  Penetrating Keratoplasty Offers Superior Best-Corrected Visual Acuity When Restoring Corneal Transparency: Presented at ARVO By Micheal Casasnovas FORT LAUDERDALE, Fla -- April 30, 2008 -- Penetrating keratoplasty is a better procedure than deep anterior lamellar keratoplasty when seeking to obtain best-corrected visual acuity for restoration of corneal transparency, according to preliminary trial results reported here at the Association for Research in Vision and Ophthalmology (ARVO) 2008 Annual Meeting. "After 2 years, the mean best-corrected visual acuity was 6/7.5 for the patients undergoing penetrating keratoplasty compared with 6/9.5 for patients undergoing deep anterior lamellar keratoplasty (P = .03)," said James L. Ball, MA, FRCOpth, Consultant Ophthalmic Surgeon, St. James's University Hospital, Leeds, United Kingdom, speaking at a poster presentation on April 28. "The penetrating keratoplasties attained better best-corrected visual acuities than the deep anterior lamellar keratoplasty." Mr. Ball led a research team in a retrospective chart review of 20 patients who underwent penetrating keratoplasties and 20 patients who underwent deep anterior lamellar keratoplasties from a keratoconic cohort that received corneal transplantation. The review was conducted at 2 and 4 years postsurgery. The patients were comparable in age, sex, and ethnicity. The procedures all were performed by one surgeon. At the 2-year mark, researchers found the mean refractive cylinder was 4.22 +- 2.64 dioptre cylinders (DC) in the penetrating keratoplasty group and 2.21 +- 1.19 DC for the deep anterior lamellar keratoplasty group (P = .02). At the 2-year mark, researchers found the mean best-corrected visual acuities were 6/5 for penetrating keratoplasty and 6/7.5 for deep anterior lamellar keratoplasty (P = .04). There was no statistically significant difference between groups for the mean postoperative spherical equivalent, Mr. Ball noted. There also was no statistically significant difference between groups for refractive error. There was a regrafting of 2 penetrating keratoplasties due to failure on the first attempt. No regrafting of the deep anterior lamellar keratoplasties was required. "Penetrating keratoplasty is the standard procedure for restoration of corneal transparency, whereby all of the corneal host tissue is replaced with healthy donor cornea," Mr. Ball explained. The transplants tend to fail due to endothelial rejection. Deep anterior lamellar keratoplasty permits the surgical treatment of a diseased cornea with preservation of healthy recipient corneal endothelium. "This procedure is more technically demanding and time-consuming than penetrating keratoplasty, however," Mr. Ball noted. [Presentation title: Mid-Term Outcomes of Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty. Abstract D944]
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