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Corneal clarity measurements in patients with keratoconus undergoing either penetrating or deep anterior lamellar keratoplasty

Authors Alzahrani K, Dardin SF, Carley F, Brahma A, Morley D, Hillarby MC

Received 16 November 2017

Accepted for publication 17 January 2018

Published 23 March 2018 Volume 2018:12 Pages 577—585


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Khaled Alzahrani,1,2 Syarifah-Faiza Dardin,1 Fiona Carley,2 Arun Brahma,2 Debbie Morley,2 M Chantal Hillarby1

1Division of Pharmacy and Optometry, School of Health Sciences, University of Manchester, Manchester, UK; 2Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

Purpose: To compare the corneal clarity measurement between penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) in patients with keratoconus, using densitometry software for the Oculus Pentacam.
Methods: A retrospective comparative study was carried out at Manchester Royal Eye Hospital. Data were collected 12–18 months after corneal transplantation for keratoconus, including postoperative corneal densitometry, best corrected visual acuity (BCVA), central corneal thickness (CCT), and other relevant clinical details.
Results: Analysis of 37 keratoconus eyes from 36 patients found there was a significantly higher corneal densitometry measurement after DALK than PK. This was predominantly in the posterior layer of the concentric zone 0–2 mm of the cornea (P=0.0004). A significant correlation was found between postoperative BCVA and corneal densitometry in DALK groups at full thickness (P=0.03). This correlation was seen in the central 0–2 mm (P=0.03) and posterior 0–2 mm (P=0.04) zones. In addition, within the DALK group, a correlation was found between central corneal thickness and densitometry at full thickness 2–6 mm (P=0.007), central 0–2 (P=0.04), central 2–6 mm (P=0.01), and at posterior 2–6 mm (P=0.01) zones.
Conclusion: This study showed that corneal densitometry measurement differs depending on the type of corneal transplantation used to treat keratoconus patients. Densitometry may have an important role to play in the final BCVA achieved by patients undergoing corneal transplantation for keratoconus. Analysis of Oculus Pentacam images provides an objective evaluation to monitor the cornea status after the surgery.

Keywords: keratocytes, corneal transplantation, corneal wound healing, keratoconus, transparency

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