Refractive results after topography-guided anterior lamellar keratoplasty with excimer laser in keratoconus grade III

Abstract

Objective: determine refractive and functional results in patients with keratoconus grade III underwent to topography-guided anterior lamellar keratoplasty assisted with excimer laser. Materials and Methods: uncontrolled experimental study, longitudinal and prospective, in 35 eyes of 31 patients with an average age of 35.3 years old, followed between 12 and 51 moths; operated at “Camilo Cienfuegos” International Center of Retinitis Pigmentosa, between January 2006 and December 2010. Results: the uncorrected visual acuity improved from 0.04 to 0.39 and the best corrected visual acuity improved from 0.28 to 0.78; the spherical equivalent was reduced from -13.02 to -1.69D. The sphere and cylinder decreased from -10.13D ± 4.73 to -0.44D ± 3.22 and from -5.67D ± 2.32 to -2.52 ±1.38, respectively. The average of the keratometry decreased from 56.8D and 51.53D to 45.02 and 42.02 in the post-surgery. The cellular density pre-surgery changed from 2313.81 cel/mm2 ± 322.10 to 2170 cel/mm2 ± 294.92 in postoperative. The residual stromal bed was 153.22 μ. Discussion: in correlation with the literature, the keratoconus appears in the adolescence and youth, leading to the corneal transplantation more often in these life stages. The average postsurgical keratometry was inferior to the reported by others investigators who practiced procedures with similar surgical technique. Conclusions: superficial anterior lamellar keratoplasty, assisted with excimer laser, can be considered as primary indication of treatment in keratoconus grade III (MÉD.UIS. 2012;25(3):195-202).