Original Article

Deep Anterior Lamellar Keratoplasty for Treatment of Keratoconus


  • Banu Torun Acar
  • Didem Esen
  • Bülent İ. Buttanrı
  • Şahin M. Sevim

Received Date: 09.12.2009 Accepted Date: 23.03.2010 Turk J Ophthalmol 2010;40(3):171-175


To evaluate the results and complications of deep anterior lamellar keratoplasty for treatment of keratoconus.

Material and Method:

Forty eyes of 40 patients with keratoconus were included in this study. In all patients, big-bubble technique was tried in order to perform deep anterior lamellar keratoplasty; when failed, manual dissection was applied. Pre- and postoperative best-corrected visual acuity, refractive results, surgical technique and complications were analyzed.


40 patients, 18 females and 22 males, with a mean age of 24.02±6.20 years (range, 15-36 years) were included in the study; the mean follow-up period was 14.92±2.39 months (range, 10-18 months). The mean postoperative refraction was -3.29±1.46D (+2.00 to -5.50D) spherically, and -4.24±0.72D (-2.50 to -5.50D) cylindrically (p<0.05). Keratometric values were 45.16±2.84D (37.30-50.89D) SimK1, and 48.50±2.78D (40.42-53.85D) SimK2. The mean postoperative pachymetry was 558.64±22.02 µm (514-614 µm) and the mean endothelial cell density was 2369.52±265.59 cell/mm2. Intraoperative microperforation of Descemet’s membrane occurred in 6 patients. In postoperative follow-up period, double anterior chamber developed in 3 eyes, epithelial defects were seen in 26 eyes, foreign bodies were detected in the graft-bed interface in 10 eyes, and suture abscess in 2 eyes. There was no endothelial rejection.


Deep anterior lamellar keratoplasty is safe and effective surgical technique in patients with keratoconus. Visual outcome is comparable to standard penetrating keratoplasty, without the risk of endothelial rejection.

Keywords: Keratoconus, deep anterior lamellar keratoplasty, Descemet’s membrane

Full Text (Turkish)