Intraoperative and Early Postoperative Complications of Deep Anterior Lamellar Keratoplasty: A Focus on First 100 Consecutive Cases.

Purpose: To investigate the peri-operative and early postoperative complications of deep anterior lamellar keratoplasty (DALK) and to evaluate the learning curve needed to complete the DALK surgery. Materials and Methods: We retrospectively analyzed the medical records of 100 eyes in 100 patients who underwent the DALK procedure due to different corneal diseases. Preoperative demographic and clinical features were evaluated along with the perioperative and early postoperative complications during the first 3 months. Results: We performed the DALK procedure successfully in 83 patients (83%) and intra-operatively decided conversion to penetrating keratoplasty (PK) procedure in the other 17 eyes (17%). The rate of conversion to PK was 40% (10 eyes) in the first 25 cases, 8% (2 eyes) in the second 25 cases, 12% (3 eyes) in the third 25 cases, and 8% (2 eyes) in the last 25 cases. There was a big bubble formation in 65 eyes (65%). The most common intra-operative complication was Descemet's membrane perforation occurred in 26 (26%) of 100 patients, 11 of which were micro-perforation, and the remaining 15 eyes had macro-perforation. The most common postoperative complications were double anterior chamber in 8 of 83 eyes (9.6%) and early suture loosening in 8 of 83 eyes (9.6%). Conclusion: The study demonstrated that in the first 25 cases, the rate of conversion to PK was higher, however, the success rate increases remarkably after the first 25 cases. [ABSTRACT FROM AUTHOR]