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Year : 2022  |  Volume : 36  |  Issue : 1  |  Page : 36-41

Deep anterior lamellar keratoplasty for keratoconus: Elements for success

Department of Translational Medicine, University of Ferrara; Department of Ophthalmology, Ospedali Privati Forlì “Villa Igea”; Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy

Correspondence Address:
Prof. Massimo Busin
Ospedali Privati Forlì 'Villa Igea', Forlì 47122
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjopt.sjopt_100_21

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Advanced keratoconus may require keratoplasty when the patient can no longer achieve functional vision with glasses and contact lenses. Deep anterior lamellar keratoplasty (DALK) has become the surgical treatment of choice due to its undisputed advantages over penetrating keratoplasty including the reduced risk of intraoperative complications, the absence of endothelial immune rejection, and the longer graft survival. Albeit “big-bubble” DALK still represents the most popular surgical method, several modifications have been developed over the years. This allowed standardization of the technique, with improved success rates and clinical outcomes. This review presents an overview on the literature on DALK surgery for keratoconus. We discuss state-of-the art surgical techniques, current evidence on the clinical outcomes and complications as well as possible future directions.

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