Comparative analysis of clinical and functional outcomes of deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus patients

To evaluate outcomes of surgical treatment of patients with keratocunus using the technique of deep anterior lamellar keratoplasty (DALK) by the aero-viscoseparation of Descemet's membrane method in a comparative aspect to results of penetrating keratoplasty (PKP).The investigated group included 100 patients (107 eyes) with keratoconus III-IV using the DALK (76 eyes of 70 patients) and the PKP (31 eyes of 30 patients). Pre- and post-operatively the standard and special diagnostic methods were used (keratotopography, keratopachymetry, anterior segment optical coherence tomography, confocal microscope). The follow-up period was 2 years. Perforation of Descemets membrane was a specific intra-operative complication in the main group (10.5%), but converting surgical technique to PKP was required only in 2.6% of cases. Endothelial cell loss 2 years after surgery was 13.6% in the DALK group and 30.8% -- in the PKP group (p