Corneal Transplantation in Keratoconus Publisher



Soleimani M¹ ; Masoumi A¹ Show Affiliations
Source: Keratoconus: Optical and Surgical Management Published:2024

Abstract

Advanced keratoconus (KCN) has historically been treated with penetrating keratoplasty (PKP), but the advent of improved surgical techniques and equipment has led to deep anterior lamellar keratoplasty (DALK) becoming the more favored approach. This chapter compares PKP and DALK in the context of treating advanced KCN, underlining the shift towards DALK due to its advantages in preserving the corneal structure and promoting faster wound healing, especially beneficial in patients with mental disabilities or those at higher risk of post-operative complications. DALK offers similar visual results to PKP, it boasts quicker visual recovery and lower endothelial cell loss, reducing the risk of endothelial rejection. However, challenges such as residual stromal tissue and the risk of large intraoperative Descemet membrane perforations can influence the visual outcomes post-DALK. While DALK presents significant advantages over PKP, careful patient selection and meticulous surgical technique are imperative for optimal outcomes in corneal transplantation for KCN. © 2025 selection and editorial matter, Mehrdad Mohammadpour and Masoud Khorrami-Nejad; individual chapters, the contributors.