Back to Journals » Clinical Ophthalmology » Volume 5

Common complications of deep lamellar keratoplasty in the early phase of the learning curve

Authors Hosny M 

Published 10 June 2011 Volume 2011:5 Pages 791—795


Review by Single anonymous peer review

Peer reviewer comments 2

Mohamed Hosny
Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

Purpose: To evaluate and record the common complications that face surgeons when they perform their first few series of deep lamellar keratoplasty and measures to avoid these.
Setting: Dar El Oyoun Hospital, Cairo, Egypt.
Methods: Retrospective study of the first 40 eyes of 40 patients carried out by two corneal surgeons working in the same center. All patients were planned to undergo a deep anterior lamellar keratoplasty using the big bubble technique. Twelve patients suffered from keratoconus while 28 patients had anterior corneal pathologies. Recorded complications were classified as either intraoperative or postoperative.
Results: Perforation of Descemet's membrane was the most common intraoperative complication. It occurred in nine eyes (22.5%): five eyes (12.5%) had microperforations while four eyes (10%) had macroperforations, three eyes (7.5%) had central perforations, and six eyes (15%) had peripheral perforations. Other complications included incomplete separation of Descemet's membrane and remnants of peripheral stromal tissue. Postoperative complications included double anterior chamber which occurred in four eyes (10%) and Descemet's membrane corrugations. Postoperative astigmatism ranged from 1.25 to 4.5 diopters with a mean of 2.86 diopters in the whole series, but in the six cases with identified residual stroma in the periphery of the host bed, the astigmatism ranged from 2.75 to 4.5 diopters with a mean of 3.62 diopters.
Conclusion: Deep lamellar keratoplasty is sensitive to procedural details. Learning the common complications and how to avoid them helps novice surgeons to learn the procedure faster.

Keywords: deep lamellar keratoplasty, complications, big bubble technique

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.