To compare the clinical and paraclinical outcomes of deep anterior lamellar keratopathy (DALK) using frozen versus fresh corneas in patients with Keratoconus

: In this prospective, interventional case-control study, 16 frozen and 19 fresh corneas were used for deep anterior lamellar keratoplasty in Keratoconus patients. The big bubble technique was used in all keratoconic patients. The outcomes were compared at 3 and 6 months after surgery with respect to best spectacle corrected visual acuity (BSCVA), graft clarity, graft epithelial defect, graft rejection and pachymetry. Also after 3 and 6 months post surgery, basal epithelial cell density, anterior and mid and posterior keratocyte density, interface haze and endothelial cell density were measured by confoscan. Finally dissimilarity of measurements from two groups were compared

: The study included 35 eyes (22 females, 13 males) with mean age of 27±5 (21-32). There was no statistically significant difference between two groups in mean BSCVA, mean central corneal thickness, basal epithelial cell density and endothelial cell density. Graft epithelial defects were improved up to seven days in both groups. The rejection free graft survival rate was 100% in two groups. Three months postoperatively, 2 eyes in frozen group were not clear in slit lamp exam (12.5%) but one of them became clear after 6 months. There was a significant difference between anterior, mid and posterior keratocyte density with mean keratocyte density of zero in 3 and 6 months postoperatively in frozen corneas. In confoscan, grade of interface haziness after 3 months were the same in both groups but after 6 months the grade of interface haze was significantly higher in frozen corneas (P<0.05)

DALK using frozen corneas seems to yield clinical and paraclinical results that are good as DALK using fresh corneas