Changes in Central Macular Thickness After Uncomplicated Corneal Transplantation for Keratoconus: Penetrating Keratoplasty Versus Deep Anterior Lamellar Keratoplasty

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Purpose:The aim of this study was to assess changes in macular thickness by means of optical coherence tomography after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) for keratoconus.Methods:This prospective study comprised 60 eyes of 60 patients who had keratoplasty for the treatment of keratoconus. Eyes were divided into 2 groups according to the keratoplastic technique applied: PKP group and DALK group. Measurements of central macular thickness were performed preoperatively and 1, 3, and 6 months after surgery.Results:The final analysis included 33 eyes in the PKP group and 24 eyes in the DALK group. In the PKP group, the central macula was found to be 6.5%, 6.3%, and 4.5% thicker in the first, third, and sixth month, respectively. Similarly, the central macula was 5.6%, 5.4%, and 2.9% thicker at months 1, 3, and 6 in the DALK group. The 2 groups did not differ significantly in terms of macular thickening. The percentage of eyes showing more than 10% increase in the macular region at any time during the follow-up period was 43.2% in the PKP group and 50.0% in the DALK group (P = 0.614). The percentage of eyes found to have a central macular thickness more than 250 μm at any time during the follow-up period was 10.8% in the PKP group and 18.2% in the DALK group (P = 0.424).Conclusions:The study showed that DALK, although it is a closed-system technique, has a similar impact on the macula compared with PKP.

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