Two-Year Outcomes of Simultaneous Double Lamellar Keratoplasty: A Novel Alternative to Repeat Penetrating Keratoplasty
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Authors
H. W. S. Roberts, P.
Myerscough, J.
Ahmad, S.
Issue Date
2025-12-12
Type
Journal Article
Language
eng
Keywords
Dalk , Dsaek , Sdlk , penetrating keratoplasty , simultaneous double lamellar keratoplasty
Alternative Title
PURPOSE: To evaluate the outcomes of Simultaneous Double Lamellar Keratoplasty (SDLK) as a surgical alternative to repeat penetrating keratoplasty (PK) for cases involving both stromal pathology and endothelial graft failure. METHODS: Three patients with failed PK and evidence of both stromal and endothelial pathology underwent SDLK. The procedure combined deep anterior lamellar keratoplasty (DALK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in a single operation. Outcome measures included uncorrected and corrected distance visual acuity (UDVA and CDVA), topographic astigmatism, and postoperative complications, assessed over a 24-month follow-up period. RESULTS: All patients achieved significant improvements in visual acuity and reduced astigmatism. Final CDVA ranged from 0.04 to 0.30 logMAR. One patient had an intraoperative microperforation, which was successfully managed. Postoperative complications included 1 case of partial DSAEK detachment, resolved with rebubbling. No graft rejections were observed. The combination of DALK and DSAEK restored corneal clarity and improved astigmatism while minimizing the risks associated with open-sky surgery. CONCLUSIONS: SDLK offers a viable alternative to repeat PK for managing combined stromal and endothelial failure. This approach preserves structural integrity, provides superior refractive outcomes, and facilitates future lamellar interventions. Further studies are warranted to validate these findings in larger cohorts.
Description
Citation
Roberts HWS, P., Myerscough, J., Ahmad, S. Two-Year Outcomes of Simultaneous Double Lamellar Keratoplasty: A Novel Alternative to Repeat Penetrating Keratoplasty. Cornea. 2025.
Publisher
Wolters Kluwer Health
License
© 2025
Journal
Cornea