Dr.Ritu Arora
Purpose:To analyze the causes and outcomes of management of failed primary anterior lamellar keratoplasty (ALK).
Methods:Medical records were reviewed to identify the incidence, causes and management of failed primary ALK.They were managed with either penetrating keratoplasty (PK) or repeat DALK in cases with normal endothelium.The clinical outcomes of re DALK/PK were evaluated.
Results:Graft failure occurred in 12 (6%) of 200 eyes undergoing primary ALK over 14 years.The causes being graft infection (1), interface opacification (5), macular dystrophy (2), type 2 bubble (2), HSV recurrence (1), graft melt (1).Successful repeat DALK and PK was done in 6 failed grafts each.All the grafts were clear with BCVA ranging from 6/36 to 6/6 at the last follow up (6 months – 5 years).
Conclusion: Re DALK is an effective treatment modality in the management of failed DALK with normal endothelium with comparable results to PK.
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