Indications and outcome of optical partial thickness lamellar keratoplasty

Purpose. To review the indications and outcome of optical partial thickness lamellar keratoplasty (LKP) over a 22-year period. Methods. The study is a retrospective review of 138 eyes of 126 patients. Snellen visual acuity, preoperative clinical condition, and postoperative clinical status were assessed. Results. Postoperative follow-up ranged from 1 month to 174 months (average, 34.5). In descending order of frequency, climatic droplet keratopathy, infectious keratitis scar, and band-shaped keratopathy were the most common indications for surgery. Follow-up records were available for 130 eyes; 93% of grafts remained transparent. One hundred eyes (80%) preoperative measured Snellen acuity of 6/60 or less., Postoperatively, only 20 eyes (13.4%) were assessed as worse than 6/60. Mean best-corrected visual acuity postoperative was 0.58 0.24. Twenty-two eyes (16.9%) demonstrated postoperative visual acuity of better than 6/12. Complications included presumed rejection in two eyes, nonhealing epithelial defect in two eyes, and graft infection in seven eyes. Conclusion. Vision gain following LKP is generally moderate (visual acuity, 6/18-6/12) in the majority of eyes (61.5%). Vision-threatening complications are low (6.9%). There is scope for reducing complications like postoperative infections and improving visual gain through deep lamellar keratoplasty.