International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 2, pp: (347-352), Month: October 2020 - March 2021, Available at: www.researchpublish.com
A CLINICAL STUDY ON VISUAL OUTCOME UNDERGOING DALK (DEEP ANTERIOR LAMELLAR KERATOPLASTY) IN KERATOCONUS PATIENT 1
Ms. Nisha Waghmare, 2Ms. Divya Sharma, 3Mr. Shishir Shukla 1
(Author), 2,3 (Co- Author)
1,2,3
DEPARTMENT OF OPTOMETRY, SHRI RAWATPURA SARKAR UNIVERSITY, RAIPUR, CHATTISGARH.
Abstract: The aim was to study the Visual outcome of keratoconus (kc) with a corneal transplantation technique Deep anterior lamellar keratoplasty (DALK). Material and Methods: This Retrospective cross sectional study included 40 patients eyes with moderate to advanced keratoconus underwent Deep anterior lamellar keratoplasty. Data were obtained by reviewing the records of 40 patients operated at National institute of Ophthalmology, Pune between June 2019 – June 2020 For Deep anterior lamellar keratoplasty Surgery. Patient at least completed 6 months follow up. Medical records were reviewed for Demographic Details , Risk Factors , Surgical procedure, size of donor , post operative complication and Visual outcome. According to the patient Record the Data was Measured and analyzed Statistically. Result: Out of 40 Operated Patients with aged between 10 – 30 years were enrolled in this study. wherein Preoperatively , corrected distance visual acuity was >6/60( < 1.00 in log mar) in 18 eyes, 6/60(1.00 in log mar) in 11eyes, 6/36(0.8 in log mar) in 8 eyes, 6/24( 0.6 in log mar ) in 3 eyes. After performing the Deep anterior lamellar keratoplasty . the corrected distance visual acuity was after 6 month 6/12 ( 0.3 in log mar ) in 6 eyes , 6/18( 0.5 in log mar ) in 11 eyes, 6/24( 0.6 in log ma r) in 9 eyes, 6/36 ( 0.8 in log mar) in 11 eyes , 6/60 ( 1.0 in log mar ) in 3 eye.Similarly , Pre operatively 18 patients (45 %) were in blindness categories according to WHO ; After performing the Deep anterior lamellar keratoplasty only 3 patients (7.5 %) were in blindness categories. Conclusion: Deep anterior lamellar keratoplasty should be procedure of choice in patient with keratoplasty induced by keratoconus. This technique causes minimal refractive change and provide rapid visual recovery for patient with keratoconus. Keywords: Keratoconus , DALK Surgery, visual outcome.
1. INTRODUCTION Cornea is an avascular, transparent tissue that is an important component of the ocular refractive system. It is one of the most densely stimulated tissues in the body. Corneal stroma is composed of cellular and acellular components . Cornea is an immune-rich tissue due to the absence of blood and lymphatic vessels. Although normal cornea is without blood vessels, many conditions can cause neovascularization, scarring, and corneal blindness. It consist of 5 layers (possibly six , if the Dua’s layer is included). From the anterior to posterior the layers of the cornea are: KERATOCONUS It is the most common primary ectasia. It usually occurs in the second decade of life and affects both genders and all ethnicities. Keratoconus (conical cornea) is a non – inflammatory biletral ( 85%) ectatic condition of cornea in its axial part. It usually starts at youth and Progresses slowly. Ocular may have signs and symptoms vary depending on disease severity. Corneal thinning frequently precedes IIO ectasia. In moderate and advance cases, placido disc examination shows irregularity of the circle. And in keratometry reading Normal average keratometric values are 45 D . In keratoconus the keratometric values are increased and based on the severity of keratoconus.
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