Keratoplasty for keratoconus: advantages and disadvantages
https://doi.org/10.21516/2072-0076-2021-14-4-130-136
Abstract
Keratoconus is a progressive bilateral corneal ectasia, accompanied by loss of vision due to high irregular astigmatism, which is the leading indication for corneal transplantation. The review presents a variety of surgical corneal transplantation techniques for keratoconus available today and discussed their advantages and disadvantages.
About the Authors
M. M. BikbovRussian Federation
Mukharram M. Bikbov — Dr. of Med. Sci., professor, director
90, Pushkin St., Ufa, 450077, Bashkortostan
E. L. Usubov
Russian Federation
Emin L. Usubov — Cand. of Med. Sci., leading researcher, department of surgery of the cornea and lens
90, Pushkin St., Ufa, 450077, Bashkortostan
A. F. Zaynetdinov
Russian Federation
Artur F. Zaynetdinov — PhD student, ophthalmologist 2 microsurgical department
90, Pushkin St., Ufa, 450077, Bashkortostan
References
1. Bikbov M.M., Bikbova G.M. Ectasia of the cornea pathogenesis, pathomorphology, clinic, diagnostics, therapy. Moscow: Oftal’mologiya. 2011 (in Russian).
2. Bikbov M.M., Bikbova G.M., Khalimov A.R., et al. Ectasia of the cornea. Selected Lectures. Мoscow: April; 2018 (in Russian).
3. Jhanji V., Sharma N., Vajpayee R.B. Management of keratoconus: current scenario. Br. J. Ophthalmol. 2011; 95 (8): 1044–50. doi: 10.1136/bjo.2010.185868
4. Bikbov M.M., Usubov E.L., Surkova V.K., et al. Clinical and epidemiological characteristics of primary keratectasias in the Republic of Bashkortostan. Tochka zrenija. Vostok–Zapad. 2016; 4: 8–10 (in Russian).
5. Sitnik G.V., Slonimskij A.Yu., Slonimskij Yu.B. Femtolaser refractive autokeratoplasty: first results and prospects. Ophthalmology in Russia. 2015; 12 (3): 22–9 (in Russian). doi:10.18008/1816-5095-2015-3-22-29
6. Sitnik G.V., Slonimskij A.Yu., Slonimskij Yu.B., Imsheneckaja T.A. Efficiency of femtolaser refractive autokeratoplasty in keratoconus. Modern technologies in ophthalmology. 2017; 3: 250–2 (in Russian).
7. Timofeev M.A., Tereshhenko A.V., Dem'janchenko S.K. Femtolaser refractive autokeratoplasty — analysis of medium-term results. Modern technologies in ophthalmology. 2019; 5: 241–4 (in Russian). doi: 10.25276/2312-4911-2019-5-241-244
8. Mamikonjan V.R., Avetisov S.E., Osipjan G.A., et al. Interlamellar bandage keratoplasty for the treatment of progressive keratoconus (preliminary report). Vestnik oftal’mologii. 2015; 131 (1): 18–23 (in Russian). doi:10.17116/oftalma2015131118-23
9. Osipjan G.A., Khrajstin Kh. Possibilities of interlayer keratoplasty in the rehabilitation of patients with keratoconus. Ophthalmology in Russia. 2019; 16 (2): 169–73 (in Russian). doi: 10.18008/1816-5095-2019-2-169-173
10. Osipjan G.A., Sheludchenko V.M., Khrajstin H. Modern surgical methods for the treatment of keratectasias. Vestnik oftal’mologii. 2019; 135 (2): 138–43 (in Russian). doi: 10.17116/oftalma2019135021138
11. Dushin N.V., Frolov M.A., Gonchar P.A. Keratoplasty in the treatment of eye diseases (optical, refractive, medical, cosmetic). Мoscow: RUDN. 2008 (in Russian).
12. Slonimskij Yu.B., Slonimskij A. Yu., Korchuganova E.A. To the question of rational administered to patients with acute keratoconus. Ophthalmology in Russia. 2015; 11 (4): 17–25 (in Russian).
13. de Toledo J.A., de la Paz M.F., Barraquer R.I., Barraquer J. Long-term progression of astigmatism after penetrating keratoplasty for keratoconus: evidence of late recurrence. Cornea. 2003 May; 22 (4): 317–23. doi: 10.1097/00003226-200305000-00008
14. Sharif K.W., Casey T.A. Penetrating keratoplasty for keratoconus: complications and long-term success. Br. J. Ophthalmol. 1991; 75 (3): 142–6. doi: 10.1136/bjo.75.3.142
15. Javadi M.A., Mohammadi M.J., Mirdehghan S.A., Sajjadi S.H. A comparison between donor-recipient corneal size and its effect on the ultimate refractive error induced in keratoconus. Cornea. 1993; 12 (5): 401–5. doi: 10.1097/00003226-199309000-00006
16. Kuryan J., Channa P. Refractive surgery after corneal transplant. Curr. Opin. Ophthalmol. 2010; 21 (4): 259–64. doi: 10.1097/ICU.0b013e32833a9abb
17. Lanier J.D., Bullington Jr.R.H., Prager T.C. Axial length in keratoconus. Cornea. 1992 May; 11 (3): 250–4. PMID:1587134.
18. Maljugin B.E., Shilova N.F., Antonova O.P., et al. Comparative analysis of the clinical and functional results of anterior deep layer-by-layer and through keratoplasty for keratoconus. Fyodorov Journal of Ophthalmic Surgery. 2015; 4: 44–9 (in Russian).
19. Fontana L., Parente G., Tassinari G. Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus. Am. J. Ophthalmol. 2007; 143 (1): 117–24. doi: 10.1016/j.ajo.2006.09.025
20. Romano V., Steger B., Kaye S.B. Spontaneous descemet membrane tear after uneventful big-bubble deep anterior lamellar keratoplasty. Cornea. 2015; 34 (4): 479–81. doi: 10.1097/ICO.0000000000000373
21. Rana M., Savant V. A brief review of techniques used to seal corneal perforation using cyanoacrylate tissue adhesive. Contact Lens and Anterior Eye. 2013; 36 (4): 156–8. doi: 10.1016/j.clae.2013.03.006
22. Sarnicola V., Toro P., Gentile D., Hannush S.B. Descemetic DALK and predescemetic DALK: outcomes in 236 cases of keratoconus. Cornea. 2010; 29 (1): 53–9. doi: 10.1097/ICO.0b013e3181a31aea
23. Bilgihan K., Ozdek S.C., Sari A., Hasanreisoglu B. Microkeratome-assisted lamellar keratoplasty for keratoconus: stromal sandwich. J. Cataract Refract. Surg. 2003; 29 (7): 1267–72. doi: 10.1016/S0886-3350(02)02055-2
24. Slonimskij Ju.B., Slonimskij A.Ju. Keratoconus today: problems and solutions. Ophthalmology in Russia. 2006; 3: 159–61 (in Russian).
25. De Benito-Llopis L., Mehta J.S., Angunawela R.I., Ang M., Tan D.T. Intraoperative anterior segment optical coherence tomography: a novel assessment tool during deep anterior lamellar keratoplasty. Am. J. Ophthalmol. 2014 Feb; 157 (2): 334–41. doi: 10.1016/j.ajo.2013.10.001
26. Amayem A.F., Anwar M. Fluid lamellar keratoplasty in keratoconus. Ophthalmology. 2000; 107 (1): 76–9. doi: 10.1016/S0161-6420(99)00002-0
27. Anwar M., Teichmann K.D. Big-bubble technique to bare descemet’s membrane in anterior lamellar keratoplasty. J. Cataract Refract. Surg. 2002; 28 (3): 398–403. doi: 10.1016/S0886-3350(01)01181-6
28. Oganesyan O.G., Makarov P.V., Grdikanjan A.A., Getadarjan V.R. New strategy for keratoplasty: dissection and dissection of the donor cornea. Russian ophthalmological journal. 2018; 11 (3): 11–8 (in Russian). doi: 10.21516/2072-0076-2018-11-3-11-18
29. Parker J.S., van Dijk K., Melles G.R.J. Treatment options for advanced keratoconus: a review. Survey of ophthalmology. 2015; 60 (5): 459–80. doi: 10.1016/j.survophthal.2015.02.004
30. Belodedova A.V., Antonova O.P., Maljugin B.E. Anterior deep lamellar keratoplasty with femto support and creation of intrastromal tunnels for the formation of a “Big-bubble” in patients with keratoconus. The first clinical and functional results. Practical medicine. 2018; 16 (4): 13–7 (in Russian)]. doi: 1032000/2072-1757-2018-16-4-13-17
31. Tereshhenko A.V., Trifanenkova I.G., Dem'janchenko S.K., Golovach N.A., Vishnjakova E.N. Optimized technology of deep anterior lamellar keratoplasty (dalk) with femtolaser support. Bulletin of Volgograd State Medical University. 2017; 1 (61): 119–20 (in Russian).
32. Melles G.R., Lander F., Rietveld F.J., et al. A new surgical technique for deep stromal, anterior lamellar keratoplasty. Br. J. Ophthalmol. 1999; 83 (3): 327–33. doi: 10.1136/bjo.83.3.327
33. Avetisov S.E. Keratoconus: modern approaches to the study of pathogenesis, diagnosis, correction and treatment. Vestnik oftal'mologii. 2014; 130 (6): 37–43 (in Russian).
34. Chentsova E.V., Rakova A.V. Anterior lamellar femtolaser keratoplasty. Practical Medicine. 2012; 1 (4): 59 (in Russian).
35. Kazakbaev R.A., Bikbov M.M., Usubov E.L., Kazakbaeva G.M. Femtolaser assisted vs manual anterior lamellar keratoplasty in patients with keratoconus. Acta Ophthalmologica. 2017; 95. doi: 10.1111/j.1755-3768.2017.0S014
36. Huang T., Zhang X., Wang Y., et al. Outcomes of deep anterior lamellar keratoplasty using the big-bubble technique in various corneal diseases. Am. J. Ophthalmol. 2012; 154: 282–9. doi: 10.1016/j.ajo.2012.02.025
37. Dem'janchenko S.K., Tereshhenko A.V., Trifanenkova I.G., Panomareva S.V. Optimized technology of deep anterior lamellar keratoplasty with femtosecond support — standardized approach. Modern technologies in ophthalmology. 2017; (5): 5–9 (in Russian).
38. Trufanov S.V., Budnikova E.A., Rozinova V.N. Modern modifications of end-to-end keratoplasty with a complex incision profile. Vestnik oftal'mologii. 2019; 135 (5–2): 260–6 (in Russian). doi: 10.17116/oftalma2019135052260
39. Shehadeh-Mashor R., Chan C.C., Bahar I., et al. Comparison between femtosecond laser mushroom configuration and manual trephine straight-edge configuration deep anterior lamellar keratoplasty. Br. J. Ophthalmol. 2014; 98 (1): 35–9. doi: 10.1136/bjophthalmol-2013-303737
40. Farid M., Kim M., Steinert R.F. Results of penetrating keratoplasty performed with a femtosecond laser zigzag incision initial report. Ophthalmology. 2007; 114: 2208–12. doi: 10.1016/j.ophtha.2007.08.048
41. Malta J.B., Soong H.K., Shtein R., et al. Femtosecond laser-assisted keratoplasty: laboratory studies in eye bank eyes. Curr. Eye Research. 2009; 34: 18–25. doi: 10.1080/02713680802535255
42. Farid M., Steinert R.F., Gaster R.N., et al. Comparison of penetrating keratoplasty performed with a femtosecond laser zig-zag incision versus conventional blade trephination. Ophthalmology. 2009; 116: 1638–43. doi: 10.1016/j.ophtha.2009.05.003
43. Maljugin B.E., Pashtaev N.P., Pashtaev A.N., et al. Femtolaser anterior layered keratoplasty: a pilot clinical study. Fyodorov Journal of Ophthalmic Surgery. 2015; 2: 24–8 (in Russian).
44. Ardjomand N., Hau S., McAlister J.C., et al. Quality of vision and graft thickness in deep anterior lamellar and penetrating corneal allografts. Am. J. Ophthalmol. 2007; 143: 228–35. doi: 10.1016/j.ajo.2006.10.043
45. Sugita J., Kondo J. Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement. Br. J. Ophthalmol. 1997; 81: 184–8. doi: 10.1136/bjo.81.3.184
46. Al-Torbak A.A., Al-Motowa S., Al-Assiri A., et al. Deep anterior lamellar keratoplasty for keratoconus. Cornea. 2006; 25: 408–12. doi: 10.1097/01.ico.0000220777.70981.46
47. Reinhart W.J., Musch D.C., Jacobs D.S., et al. Deep anterior lamellar keratoplasty as an alternative to penetrating keratoplasty a report by the American Academy of Ophthalmology. Ophthalmology. 2011; 118: 209–18. doi: 10.1016/j.ophtha.2010.11.002
48. Chen Y., Hu D.N., Xia Y., et al. Comparison of femtosecond laser-assisted deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus. BMC ophthalmology. 2015 Oct; 27 (15): 144. doi: 10.1186/s12886-015-0140-x
49. Zhang Y.M., Wu S.Q., Yao Y.F. Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus. J. Zhejiang Univ. Sci. B. 2013 May; 14 (5): 438–50. doi: 10.1631/jzus.B1200272
50. Abdelkader A., Kaufman H.E. Descemetic versus pre-descemetic lamellar keratoplasty: clinical and confocal study. Cornea. 2011; 30 (11): 1244–52. doi: 10.1097/ICO.0b013e318219bc1a
51. Musa F.U., Patil S., Rafiq O., et al. Long-term risk of intraocular pressure elevation and glaucoma escalation after deep anterior lamellar keratoplasty. Clin. Exp. Ophthalmol. 2012; 40 (8): 780–5. doi: 10.1111/j.1442-9071.2012.02796.x
52. Niknam S., Rajabi M.T. Fixed dilated pupil (Urrets — Zavalia syndrome) after deep anterior lamellar keratoplasty. Cornea. 2009; 28 (10): 1187–90. doi: 10.1097/ICO.0b013e31819aa9ff
53. Lu Y., Grisolia A.B.D., Ge Y.R., et al. Comparison of femtosecond laser-assisted descemetic and predescemetic lamellar keratoplasty for keratoconus. Indian journal of ophthalmology. 2017; 65 (1): 19. doi: 10.4103/ijo.IJO_688_16
54. Izmajlova S.B., Maljugin B.E., Novikov S.V., et al. A method of conducting keratoplasty with simultaneous implantation of an intrastromal ring for the prevention of postoperative astigmatism. Patent RF № 2674889, 13.12.2018 (in Russian).
55. Girard L.J., Eguez I., Esnaola N., Barnett L., Maghraby A. Effect of penetrating keratoplasty using grafts of various sizes on keratoconic myopia and astigmatism. J. Cataract Refract. Surg. 1988; 14: 541–7. doi: 10.1016/S0886-3350(88)80013-0
56. Mosca L., Fasciani R., Tamburelli C., et al. Femtosecond laser-assisted lamellar keratoplasty: Early results. Cornea 2008; 27: 668–72. doi: 10.1097/ICO.0b013e31816736b1
57. Doyle S.J., Harper C., Marcyniuk B., Ridgway A.E. Prediction of refractive outcome in penetrating keratoplasty for keratoconus. Cornea 1996 Sep; 15: 441–5. PMID: 8862918
58. Sarnicola V., Toro P., Gentile D., Hannush S.B. Descemetic DALK and predescemetic DALK: outcomes in 236 cases of keratoconus. Cornea. 2010; 29 (1): 53–9. doi: 10.1097/ICO.0b013e3181a31aea
59. Niziol L.M., Musch D.C., Gillespie B.W., Marcotte L.M., Sugar A. Long-term outcomes in patients who received a corneal graft for keratoconus between 1980 and 1986. Am. J. Ophthalmol. 2013; 155 (2): 213–9. doi: 10.1016/j.ajo.2012.08.001
60. Brookes N.H., Niederer R.L., Hickey D., McGhee C.N., Sherwin T. Recurrence of keratoconic pathology in penetrating keratoplasty buttons originally transplanted for keratoconus. Cornea. 2009; 28 (6): 688–93. doi: 10.1097/ICO.0b013e3181967024
61. Feizi S., Javadi M.A., Rezaei K.M. Recurrent keratoconus in a corneal graft after deep anterior lamellar keratoplasty. J. Ophthalmic Vis. Res. 2012 Oct; 7 (4): 328–31. PMID: 23503805
62. Dang T.Q., Molchan R.P., Taylor KR., et al. Novel approach for the treatment of corneal ectasia in a graft. Cornea. Mar; 33 (3): 310–2. doi: 10.1097/ICO.0000000000000052
63. Kanavi M.R., Foroutan A.R., Kamel M.R., Afsar N., Javadi M.A. Candida interface keratitis after deep anterior lamellar keratoplasty: clinical, microbiologic, histopathologic, and confocal microscopic reports. Cornea. 2007 Sep; 26 (8): 913–6. doi: 10.1097/ICO.0b013e3180ca9a61
64. Zarei-Ghanavati S., Sedaghat M.R., Ghavami-Shahri A. Acute Klebsiellapneumoniae interface keratitis after deep anterior lamellar keratoplasty. Jpn J Ophthalmol. 2011; 55 (1): 74–6.
65. Murthy S.I., Jain R., Swarup R., Sangwan V.S. Recurrent non-tuberculous mycobacterial keratitis after deep anterior lamellar keratoplasty for keratoconus. BMJ Case Rep. 2013; 2013. doi: 10.1136/bcr-2013-200641
66. Hashemian M.N., Zare M.A., Rahimi F., Mohammadpour M. Deep intrastromal bevacizumab injection for management of corneal stromal vascularization after deep anterior lamellar keratoplasty, a novel technique. Cornea. 2011 Feb; 30 (2): 215–8. doi: 10.1097/ICO.0b013e3181e291a6
67. Bikbov M.M., Bikbova G.M. Current aspects of keratoconus surgery. Vestnik Orenburgskogo gosudarstvennogo universiteta. 2008; 12–2 (in Russian).
68. van Dijk K., Parker J., Tong C.M., et al. JAMA Ophthalmol. 2014; 132 (4): 495–501. doi:10.1001/jamaophthalmol.2013.5841
69. Oganesyan O.G., Getadaryan V.R., Makarov P.V., Grdikanyan A.A. Bowman layer transplantation in eyes with progressive advanced keratoconus. Russian ophthalmological journal. 2019; 12 (4): 43–50 (in Russian). doi: 10.21516/2072-0076-2019-12-4-43-50
70. Oganesyan O., Getadaryan V., Oganesyan C., van Dijk K., Melles G. Intrastromal descemet membrane transplantation as a potential alternative to bowman layer inlays in eyes with advanced keratoconus. Eye & Contact Lens. 2021 Apr 1; 47 (4): 223–5. doi: 10.1097/ICL.0000000000000749
Review
For citations:
Bikbov M.M., Usubov E.L., Zaynetdinov A.F. Keratoplasty for keratoconus: advantages and disadvantages. Russian Ophthalmological Journal. 2021;14(4):130-136. (In Russ.) https://doi.org/10.21516/2072-0076-2021-14-4-130-136