ALTK & DSAEK offer fast visual recovery

Automated lamellar therapeutic keratoplasty (ALTK) and Descemet stripping automated endothelial keratoplasty (DSAEK) are both safe and effective techniques for corneal transplantation, according to Paolo Garimoldi and colleagues from Ospedale di Circolo, Italy.

Twenty eyes, 18 affected by keratocone and 2 by stromal opacity for herpes simplex keratitis, underwent ALTK. In eyes with keratocone, releasing penetrating stromal incisions were performed and a thicker graft obtained from a donor cornea, which was transplanted. The 18 eyes affected by Fuchs endothelial dystrophy underwent DSAEK; after removing the endothelium and Descemet membrane, a graft of deep stroma and endothelium from the donor cornea was inserted in the anterior chamber and positioned with an air-bubble.

Eyes treated with ALTK demonstrated very good graft transparency and an excellent quality of interface. No rejection reactions were noted and early temporary de-epithelialization occurred in 20% of cases. Best corrected visual acuity (BCVA) was 0.6 or better in 90% of subjects after three months follow-up. The eyes treated with DSAEK demonstrated a progressive increase of corneal transparency and the BCVA was 0.5 or better in 70% of cases after three months follow-up.

It was concluded that both procedures are safe and effective, particularly with regards the fast visual recovery and low level of complications.