VT185 : Repeat deep anterior lamellar keratoplasty for failed primary deep anterior lamellar keratoplasty.

Dr.Ritu Arora, Dr.Radhika Dashputra

Anterior lamellar keratoplasty (ALK) was performed in 200 eyes for varied indications. Graft failure occurred in 12 eyes (6%) during follow up ranging from 4 months to 14 years. The causes of graft failure were graft infection (1), interface opacification (5), macular dystrophy (2), type 2 bubble (2), HSV recurrence (1), graft melt (1). Repeat DALK was done successfully in 6 out of the 12 failed ALK grafts having normal endothelium. The failed graft could be dissected easily intraoperatively (manually or with big bubble technique). Most common complication noted was microperforation (1) which did not require conversion to penetrating keratoplasty(PK). All grafts were attached and clear with BCVA ranging from 6/36 to 6/6 at the most recent follow up (6 months – 5 years). The average thickness of the residual host cornea was 30 microns on ASOCT. Repeat DALK is a successful treatment modality for failed DALK with normal endothelium.