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Controversies in the Management of Keratoconus pp 297–307Cite as

Why Perform Deep Anterior Lamelar Keratoplasty and Not Full-Thickness Keratoplasty for the Treatment of Keratoconus

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Abstract

Keratoconus (KC) is a noninflammatory progressive corneal ectasia. It is characterized by the irregular astigmatism produced by both central and peripheral corneal stromal thinning. It is a relatively common pathology of unknown etiology. Many patients with mild or moderate KC can improve their best-corrected visual acuity (BCVA) by wearing glasses or hard contact lenses. Keratoplasty is indicated in advanced KC cases when the vision does not improve after optical correction or when there is corneal scarring that alters the transparency of the cornea.

Penetrating keratoplasty (PK) has been the gold-standard surgery for the treatment of advanced KC for many years. This procedure involves replacing the normal endothelium in young patients, which is normal in the vast majority of cases. In recent years, deep anterior lamellar keratoplasty (DALK) has proven to be an excellent alternative to PK for patients with KC. DALK provides visual outcomes comparable to those achieved with PK and it has the advantage of preserving the patient’s endothelium and thus reducing the rejection rate. In this chapter we want to explain DALK surgical technique and its advantages and disadvantages.

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Authors and Affiliations

  1. Cornea and Refractive Surgery Unit at Institut de Microcirurgia Ocular, Barcelona, Spain

    Víctor Sergio Eguiza, Julia Martinez, Merce Morral, Óscar Gris, Daniel Elies, Míriam Barbany, Spyridoula Souki, Felicidad Manero Vidal & Jose Luis Güell

  2. Federal University of São Paulo, Cornea and External Disease Department, São Paulo, SP, Brazil

    Francisco Bandeira

  3. Faculty of the European School for Advanced Studies in Ophthalmology (ESASO), Associate Professor of Ophthalmology at the Universitat Autonoma de Barcelona (UAB), Barcelona, Spain

    Jose Luis Güell

Authors
  1. Víctor Sergio Eguiza
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  2. Julia Martinez
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  3. Merce Morral
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  4. Óscar Gris
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  5. Daniel Elies
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  6. Míriam Barbany
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  7. Francisco Bandeira
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  8. Spyridoula Souki
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  9. Felicidad Manero Vidal
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  10. Jose Luis Güell
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Corresponding author

Correspondence to Jose Luis Güell .

Editor information

Editors and Affiliations

  1. Medical Director of IVISION, Refractive Surgery and Keratoconus Treatment Center, Haifa, Israel

    Adel Barbara

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Eguiza, V.S. et al. (2019). Why Perform Deep Anterior Lamelar Keratoplasty and Not Full-Thickness Keratoplasty for the Treatment of Keratoconus. In: Barbara, A. (eds) Controversies in the Management of Keratoconus . Springer, Cham. https://doi.org/10.1007/978-3-319-98032-4_25

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  • DOI: https://doi.org/10.1007/978-3-319-98032-4_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98031-7

  • Online ISBN: 978-3-319-98032-4

  • eBook Packages: MedicineMedicine (R0)

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