Outcomes of Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty for Keratoconus in a University Teaching Hospital

Purpose: To compare outcomes of penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) in keratoconic eyes in a university teaching hospital setting Methods: In this longitudinal cross-sectional study all patients who underwent PK or DALK for keratoconus at 2 years period were included to the study. The patients were recalled and complete eye examination including best spectacle corrected visual acuity (BSCVA), refraction, topography and contrast sensitivity were accomplished and the results were compared in the two groups. Results: A total of 106 patients underwent PK or DALK for keratoconus which were included in our study, of them 57 eyes underwent PK and 49 eyes underwent DALK. Mean follow-up time in PK and DALK groups were 35.0±2.4 and 30.3±2.5 Mo respectively (P=0.17). The mean postoperative BSCVA in DALK group was 0.28±0.04 logMAR and in PK group was 0.28±0.03 logMAR (P=0.99). The postoperative mean SE in PK and DALK groups were -2.74±0.58 diopter (D) and -3.46±0.52 D, respectively (P=0.36). Mean topographic Astigmatism in PK group was 3.81±0.28 and in DALK group was 4.21±0.42 (P=0.42). The contrast sensitivity functions (CSFs) in all spatial frequencies in DALK group was significantly lower than PK group. One graft in PK group and four grafts in DALK group were failed during follow-up time. Conclusion: Visual and refractive outcomes in PK and DALK for keratoconus are comparable. Whereas CSFs were lower in DALK in comparison to PK and graft failure was higher in DALK.