Avaliação da ceratoplastia lamelar anterior profunda em pacientes com ceratocone

• Autor(a) principal: Macedo, Jarbas Pereira de [UNIFESP]
• Data de Publicação: 2009
• Outros Autores: Forseto, Adriana dos Santos [UNIFESP], Allemann, Norma [UNIFESP], Sousa, Luciene Barbosa de
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-27492009000400010; http://repositorio.unifesp.br/handle/11600/5168
• topic: Cornea; Corneal transplantation; Keratoconus; Postoperative complications; Microscopy, confocal; Ophthalmologic surgical procedures; Córnea; Transplante de córnea; Ceratocone; Complicações pós-operatórias; Microscopia confocal; Procedimentos cirúrgicos oftalmológicos

PURPOSE: To evaluate the efficacy, complications and confocal microscopy corneal features of deep anterior lamellar keratoplasty using the air dissection technique in keratoconus. METHODS: Seventeen eyes with advanced keratoconus were submitted to this technique. Postoperative visual acuity and complication rate were analyzed. The thicknesses of full cornea tissue, host bed and donor button were measured, donor-host interface was also evaluated using confocal microscopy. RESULTS: Best-spectacle corrected visual acuity was 0.5 or better in 50% of the eyes. Complications occurred in five of seventeen patients (29.41%). Confocal microscopy demonstrated in four eyes the presence of hiperreflective structures at the interface, suggesting deposits and striae. Average corneal pachymetry, donor button and host bed thicknesses were respectively 609.00 ± 77.55 µm, 516.55 ± 43.65 µm and 92.50 ± 60.10 µm. CONCLUSIONS: Although technically challenging with the risk of intraoperative Descemet's membrane perforation, deep anterior lamellar keratoplasty with air dissection technique presents as an option for keratoconus treatment. Confocal microscopy demonstrated to be a useful method not only for the pachymetry measurement but also for the evaluation of interface by observing the absence of opacities in most of the cases.