Derin Anterior Lameller Keratoplastide Komplikasyonlar ve Yönetimi

Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar\udkeratoplasty (DALK) surgery.\udMaterials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK\udusing Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative\udand postoperative complications as well as the management and treatment of these complications were evaluated.\udResults: Big bubble was created in 220 (77.5%) eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5%) eyes.\udPerforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK). Intraoperative\udmicroperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air\udinjection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC) occurred in 32 of 40 eyes. DAC\udspontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved\udin 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period,\udthis eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed.\udConclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific\udcomplications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40