To assess the efficacy of deep anterior lamellar keratoplasty (DALK) for treating post-LASIK keratectasia

In this interventional case series, DALK was performed using the Melles manual technique by a single surgeon. Pre- and post-operative best spectacle visual acuity (BSCVA), spherical equivalent (SE) refraction, mean keratometry, apical keratometry, keratometric astigmatism, and endothelial cell profile were compared

The study cohort comprised 20 eyes of 18 patients (mean age 29 ± 4 years, 72% female). The mean follow-up was 27.6 ± 18.9 (range 6 to 60) months. The mean Snellen BSCVA improved from 20/191 before DALK to 20/23 after DALK (P<0.001). The modulus of mean SE refraction was 11.8±5.5 D and 11.2±4.3 D before and after DALK, respectively (P=0.305). The mean keratometry was 51.3±5.1 D preoperatively and 46.4±2.0 D postoperatively (P=0.002), the apical keratometry, 59.5±5.1 and 49.9±2.6 D (P<0.001), and the mean keratometric astigmatism, 3.8±1.8 and 2.2±1.7 D, respectively (P=0.029). The endothelial cell profile did not change significantly after DALK. No major complications related to DALK were occurred. Ten eyes underwent addition refractive procedure to correct residual myopia.

Deep anterior lamellar keratoplasty using the manual technique is effective and safe in restoring BSCVA in patients with post-LASIK keratectasia; however, high residual myopia is a common finding