Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 11/2014

01-11-2014 | Cornea

Comparison of deep anterior lamellar keratoplasty and penetrating keratoplasty with respect to postoperative corneal sensitivity and tear film function

Authors: Xiaolei Lin, Binbin Xu, Yifang Sun, Jing Zhong, Weilan Huang, Jin Yuan

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 11/2014

Login to get access

Abstract

Purpose

To investigate tear film function, central and peripheral corneal sensitivity and corneal subbasal nerve morphology in the cornea after deep anterior lamellar keratoplasty (DALK) compared with penetrating keratoplasty (PK).

Methods

This prospective study compared the changes in 16 eyes of 16 patients who underwent DALK (DALK group) with those in 28 eyes of 28 patients who underwent PK (PK group). Thirty healthy volunteers were also included as controls. Tear functions were evaluated using tear break-up time (TBUT), tear meniscus height (TMH) and corneal fluorescein staining. Corneal sensation was measured with a Cochet-Bonnet esthesiometer. Corneal subbasal nerve morphology was evaluated using in vivo confocal microscopy (IVCM). The patients were examined 1, 3, 6, 9 and 12 months after keratoplasty.

Results

Postoperatively, TMH recovered significantly faster in the DALK group than in the PK group (p < 0.05), and the postoperative TBUT was much higher in the DALK group compared with the PK group (p < 0.05). Central and peripheral corneal sensitivity remained lower in both the PK and DALK groups at 12 months after surgery compared with the control group (p < 0.05). The peripheral corneal sensitivity of the host cornea was significantly higher than the central corneal sensitivity (p < 0.05). No significant difference was found in corneal sensitivity between the PK and DALK groups. There was no significant correlation between corneal sensitivity and tear film function after PK or DALK.

Conclusions

Tear film function was restored more rapidly after DALK compared with PK, but there was no significant difference in corneal sensitivity between PK and DALK.
Literature
1.
The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5: 93–107
2.
McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR (1998) The epidemiology of dry eye in Melbourne, Australia. Ophthalmology 105:1114–1119PubMedCrossRef
3.
Lin PY, Tsai SY, Cheng CY, Liu JH, Chou P, Hsu WM (2003) Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study. Ophthalmology 110:1096–1101PubMedCrossRef
4.
Hirayama Y, Satake Y, Hirayama M, Shimazaki-Den S, Konomi K, Shimazaki J (2013) Changes in corneal sensation, epithelial damage, and tear function after descemet stripping automated endothelial keratoplasty. Cornea 32:1255–1259PubMedCrossRef
5.
Management and therapy of dry eye disease: report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5:163–178
6.
Muller LJ, Marfurt CF, Kruse F, Tervo TM (2003) Corneal nerves: structure, contents and function. Exp Eye Res 76:521–542PubMedCrossRef
7.
Fu Y, Liu J, Tseng SC (2012) Ocular surface deficits contributing to persistent epithelial defect after penetrating keratoplasty. Cornea 31:723–729PubMedCrossRef
8.
Darwish T, Brahma A, Efron N, O’Donnell C (2007) Subbasal nerve regeneration after penetrating keratoplasty. Cornea 26:935–940PubMedCrossRef
9.
Hara S, Kojima T, Dogru M, Uchino Y, Goto E, Matsumoto Y, Kawakita T, Tsubota K, Shimazaki J (2013) The impact of tear functions on visual outcome following keratoplasty in eyes with keratoconus. Graefes Arch Clin Exp Ophthalmol 251:1763–1770PubMedCrossRef
10.
Oh BL, Kim MK, Wee WR (2013) Comparison of clinical outcomes of same-size grafting between deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus. Korean J Ophthalmol 27:322–330PubMedCentralPubMedCrossRef
11.
Ceccuzzi R, Zanardi A, Fiorentino A, Tinelli C, Bianchi PE (2010) Corneal sensitivity in keratoconus after penetrating and deep anterior lamellar keratoplasty. Ophthalmologica 224:247–250PubMedCrossRef
12.
Al-Aqaba MA, Otri AM, Fares U, Miri A, Dua HS (2012) Organization of the regenerated nerves in human corneal grafts. Am J Ophthalmol 153:29–37PubMedCrossRef
13.
Anwar M, Teichmann KD (2002) Big-bubble technique to bare Descemet’s membrane in anterior lamellar keratoplasty. J Cataract Refract Surg 28:398–403PubMedCrossRef
14.
De Paiva CS, Pflugfelder SC (2004) Corneal epitheliopathy of dry eye induces hyperesthesia to mechanical air jet stimulation. Am J Ophthalmol 137:109–115PubMedCrossRef
15.
Sakata LM, Wong TT, Wong HT, Kumar RS, Htoon HM, Aung HT, He M, Aung T (2010) Comparison of Visante and slit-lamp anterior segment optical coherence tomography in imaging the anterior chamber angle. Eye (Lond) 24:578–587CrossRef
16.
Leung CK, Cheung CY, Li H, Dorairaj S, Yiu CK, Wong AL, Liebmann J, Ritch R, Weinreb R, Lam DS (2007) Dynamic analysis of dark–light changes of the anterior chamber angle with anterior segment OCT. Invest Ophthalmol Vis Sci 48:4116–4122PubMedCrossRef
17.
Koh S, Maeda N, Nakagawa T, Nishida K (2012) Quality of vision in eyes after selective lamellar keratoplasty. Cornea 31(Suppl 1):S45–S49PubMedCrossRef
18.
Kosker M, Duman F, Suri K, Hammersmith KM, Nagra PK, Rapuano CJ (2013) Long-term results of keratoplasty in patients with herpes zoster ophthalmicus. Cornea 32:982–986PubMedCrossRef
19.
Stern ME, Gao J, Siemasko KF, Beuerman RW, Pflugfelder SC (2004) The role of the lacrimal functional unit in the pathophysiology of dry eye. Exp Eye Res 78:409–416PubMedCrossRef
20.
Situ P, Simpson TL (2010) Interaction of corneal nociceptive stimulation and lacrimal secretion. Invest Ophthalmol Vis Sci 51:5640–5645PubMedCrossRef
21.
Sitompul R, Sancoyo GS, Hutauruk JA, Gondhowiardjo TD (2008) Sensitivity change in cornea and tear layer due to incision difference on cataract surgery with either manual small-incision cataract surgery or phacoemulsification. Cornea 27(Suppl 1):S13–S18PubMedCrossRef
22.
Herrmann WA, Shah CP, von Mohrenfels CW, Gabler B, Hufendiek K, Lohmann CP (2005) Tear film function and corneal sensation in the early postoperative period after LASEK for the correction of myopia. Graefes Arch Clin Exp Ophthalmol 243:911–916PubMedCrossRef
23.
Belmonte C, Acosta MC, Gallar J (2004) Neural basis of sensation in intact and injured corneas. Exp Eye Res 78:513–525PubMedCrossRef
24.
Qiu X, Gong L, Lu Y, Jin H, Robitaille M (2012) The diagnostic significance of Fourier-domain optical coherence tomography in Sjogren syndrome, aqueous tear deficiency and lipid tear deficiency patients. Acta Ophthalmol 90:e359–e366PubMedCrossRef
25.
Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5: 108–152
26.
Zhou S, Li Y, Lu AT, Liu P, Tang M, Yiu SC, Huang D (2009) Reproducibility of tear meniscus measurement by Fourier-domain optical coherence tomography: a pilot study. Ophthalmic Surg Lasers Imaging 40:442–447PubMedCentralPubMedCrossRef
27.
Ibrahim OM, Dogru M, Takano Y, Satake Y, Wakamatsu TH, Fukagawa K, Tsubota K, Fujishima H (2010) Application of visante optical coherence tomography tear meniscus height measurement in the diagnosis of dry eye disease. Ophthalmology 117:1923–1929PubMedCrossRef
28.
Ohguchi T, Kojima T, Ibrahim OM, Nagata T, Shimizu T, Shirasawa T, Kawakita T, Satake Y, Tsubota K, Shimazaki J, Ishida S (2013) The effects of 2 % rebamipide ophthalmic solution on the tear functions and ocular surface of the superoxide dismutase-1 (sod1) knockout mice. Invest Ophthalmol Vis Sci 54:7793–7802PubMedCrossRef
29.
Szczesna DH, Kulas Z, Kasprzak HT, Stenevi U (2009) Examination of tear film smoothness on corneae after refractive surgeries using a noninvasive interferometric method. J Biomed Opt 14:64029CrossRef
30.
Tung CI, Perin AF, Gumus K, Pflugfelder SC (2014) Tear meniscus dimensions in tear dysfunction and their correlation with clinical parameters. Am J Ophthalmol 157:301–310PubMedCrossRef
31.
Huang T, Lee EJ, Planck SR, Rosenbaum JT (2012) The effects of corneal endothelium on graft survival in a murine model of lamellar keratoplasty. Ophthalmic Res 47:128–134PubMedCrossRef
32.
Treseler PA, Foulks GN, Sanfilippo F (1986) The relative immunogenicity of corneal epithelium, stroma, and endothelium. The role of major histocompatibility complex antigens. Transplantation 41:229–234PubMedCrossRef
33.
Steven P, Hos D, Heindl LM, Bock F, Cursiefen C (2013) Immune reactions after DMEK, DSAEK and DALK. Klin Monbl Augenheilkd 230:494–499PubMedCrossRef
34.
Jeong S, Ledee DR, Gordon GM, Itakura T, Patel N, Martin A, Fini ME (2012) Interaction of clusterin and matrix metalloproteinase-9 and its implication for epithelial homeostasis and inflammation. Am J Pathol 180:2028–2039PubMedCentralPubMedCrossRef
35.
Mathers WD, Jester JV, Lemp MA (1988) Return of human corneal sensitivity after penetrating keratoplasty. Arch Ophthalmol 106:210–211PubMedCrossRef
36.
Stamer L, Bohnke M, Draeger J (1987) Development of corneal sensitivity following keratoplasty. Fortschr Ophthalmol 84:432–435PubMed
37.
Rao GN, John T, Ishida N, Aquavella JV (1985) Recovery of corneal sensitivity in grafts following penetrating keratoplasty. Ophthalmology 92:1408–1411PubMedCrossRef
38.
Golebiowski B, Papas E, Stapleton F (2011) Assessing the sensory function of the ocular surface: implications of use of a non-contact air jet aesthesiometer versus the Cochet-Bonnet aesthesiometer. Exp Eye Res 92:408–413PubMedCrossRef
39.
Richter A, Slowik C, Somodi S, Vick HP, Guthoff R (1996) Corneal reinnervation following penetrating keratoplasty–correlation of esthesiometry and confocal microscopy. Ger J Ophthalmol 5:513–517PubMed
40.
Niederer RL, Perumal D, Sherwin T, McGhee CN (2007) Corneal innervation and cellular changes after corneal transplantation: an in vivo confocal microscopy study. Invest Ophthalmol Vis Sci 48:621–626PubMedCrossRef
41.
Szaflik JP (2007) Comparison of in vivo confocal microscopy of human cornea by white light scanning slit and laser scanning systems. Cornea 26:438–445PubMedCrossRef
42.
Patel SV, Erie JC, McLaren JW, Bourne WM (2007) Keratocyte density and recovery of subbasal nerves after penetrating keratoplasty and in late endothelial failure. Arch Ophthalmol 125:1693–1698PubMedCrossRef
43.
Patel DV, McGhee CN (2006) Mapping the corneal sub-basal nerve plexus in keratoconus by in vivo laser scanning confocal microscopy. Invest Ophthalmol Vis Sci 47:1348–1351PubMedCrossRef
Metadata
Title
Comparison of deep anterior lamellar keratoplasty and penetrating keratoplasty with respect to postoperative corneal sensitivity and tear film function
Authors
Xiaolei Lin
Binbin Xu
Yifang Sun
Jing Zhong
Weilan Huang
Jin Yuan
Publication date
01-11-2014
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 11/2014
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-014-2748-6

Other articles of this Issue 11/2014

Graefe's Archive for Clinical and Experimental Ophthalmology 11/2014 Go to the issue

Letter to the Editor (by invitation)

Fluorescein angiography versus spectral domain optical coherence tomography in idiopathic juxtafoveal retinal telangiectasia

Genetics

Next generation sequencing uncovers a missense mutation in COL4A1 as the cause of familial retinal arteriolar tortuosity

Inflammatory Disorders

Posterior segment findings of ocular cytomegalovirus infection in immunocompetent patients

Retinal Disorders

Effect of aflibercept in insufficient responders to prior anti-VEGF therapy in neovascular AMD

Glaucoma

Investigation of blood flow regulation and oxygen saturation of the retinal vessels in primary open-angle glaucoma

Basic Science

Hyperthermia-induced upregulation of vascular endothelial growth factor in retinal pigment epithelial cells is regulated by mitogen-activated protein kinases