RT Journal Article
SR Electronic
T1 Ten-year outcomes of microkeratome-assisted lamellar keratoplasty for keratoconus
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1651
OP 1655
DO 10.1136/bjophthalmol-2020-317253
VO 105
IS 12
A1 Angeli Christy Yu
A1 Elena Franco
A1 Lorenzo Caruso
A1 James Myerscough
A1 Rossella Spena
A1 Fiorella Fusco
A1 Sergiu Socea
A1 Cristina Bovone
A1 Massimo Busin
YR 2021
UL http://bjo.bmj.com/content/105/12/1651.abstract
AB Background/Aims To report the 10-year outcomes of modified microkeratome-assisted lamellar keratoplasty (LK) for keratoconus.Methods In this single-centre interventional case series, 151 consecutive eyes with keratoconus underwent modified microkeratome-assisted LK. Eyes with scars extending beyond the posterior half of the corneal stroma and preoperative thinnest-point pachymetry value of less than 300 μm were excluded. Outcome measures were best spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA), endothelial cell density, immunological rejection, ectasia recurrence and graft failure rates.Results Baseline BSCVA (0.89±0.31 logarithm of the minimum angle of resolution (logMAR)) significantly improved to 0.10±0.12 logMAR at year 3 (p<0.001), and remained stable up to 10 years. At 10 years, 94% of eyes saw ≥20/40, 61% saw ≥20/25 and 24% saw ≥20/20 Snellen BSCVA. At final follow-up, RA exceeding 4.5 dioptres was observed in 5 cases (4%). Endothelial cell loss was 25±17% at 1 year with an annual decline of 2% over 10 years. The 10-year cumulative risk for immunological rejection and graft failure was 8.5%, and 2.4%, respectively. No case developed recurrent ectasia at 10 years.Conclusion Modified microkeratome-assisted LK results in stable visual and refractive outcomes with low rates of immunological rejection and graft failure in the absence of recurrence of ectasia for at least 10 years.