Universität zu Köln

Cursiefen, C., Schaub, F. and Bachmann, B. (2016). Update: Deep anterior lamellar keratoplasty (DALK) for keratoconus. When, how and why. Ophthalmologe, 113 (3). S. 204 - 212. NEW YORK: SPRINGER. ISSN 1433-0423

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Abstract

The treatment of keratoconus has been significantly expanded in recent years. In addition to the previous options for correction by fitting hard contact lenses and penetrating keratoplasty (PK), corneal cross-linking and lamellar transplantation techniques have been added. The aim of this review article is to highlight currently available options for minimization of complications and standardization of deep anterior lamellar keratoplasty (DALK) for keratoconus. This article summarizes our own data and gives a review of the literature in PubMed. Performing DALK can provide keratoconus patients with corneal grafts with considerably longer graft survival and a reduced risk of complications. The DALK procedure provides numerous advantages over PK, especially the reduced intraoperative opening of the eye, which thus reduces the risk of serious intraoperative complications. A further benefit is the complete absence of postoperative endothelial immune reactions as the recipient's endothelium remains untouched. The absence of endothelial immune reactions is especially advantageous for young patients with keratoconus and patients with an increased risk of graft rejection, e.g. in atopic dermatitis; however, there are also typical complications of DALK that do not occur during PK. The outlined strategies for standardization of DALK and avoidance of intraoperative and postoperative complications should make DALK safer and more reproducible and lead to possible establishment as a standard procedure in keratokonus.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cursiefen, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaub, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-282715
DOI:	10.1007/s00347-015-0204-6
Journal or Publication Title:	Ophthalmologe
Volume:	113
Number:	3
Page Range:	S. 204 - 212
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0423
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPTICAL COHERENCE TOMOGRAPHY; BIG-BUBBLE TECHNIQUE; PENETRATING KERATOPLASTY; FEMTOSECOND LASER; VISUAL-ACUITY; SURGERY; LAYER Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28271