Study finds, Effect of Previous Crosslinking on Intraoperati
A Study was conducted to compare surgical outcomes and intraoperative and postoperative complications of big-bubble deep anterior lamellar keratoplasty (DALK) in patients with and without a history of previous corneal collagen crosslinking (CXL) for keratoconus.

Patients with keratoconus who underwent DALK surgery with big-bubble technique were retrospectively reviewed. Operative findings, intraoperative and postoperative complications, and visual and refractive outcomes were recorded. Patients were divided into 2 groups: with previous CXL (CXL-DALK group: 27 eyes) and without previous CXL (DALK group: 50 eyes). All parameters were compared between groups.

Results:
--Big bubble was successfully achieved in 24 eyes in the CXL-DALK group and in 45 eyes in the DALK group.

--Type 1 bubble was obtained in 22 eyes in the CXL-DALK group and in 42 eyes in the DALK group.

--Intraoperative microperforation occurred in 3 eyes in the CXL-DALK group and in 5 eyes in the DALK group.

--Visual and refractive outcomes were similar between groups. The mean endothelial cell loss rates were 5.7% ± 2.3 at 1 year and 10.2 ± 3.1 at 2 years in the CXL-DALK group and 6.4% ± 4.7 at 1 year and 10.9% ± 5.4 at 2 years in the DALK group.

--Postoperatively, persistent epithelial defect was the most common complication in both groups, and postoperative complication rates were similar between groups.

The results showed that the success of bubbles did not effect previous CXL therapy and did not raise the intraoperative or postsurgical complication rate of keratoconus DALK surgery. Between treatment and untreated eyes CXL after 2 years of follow-up, the improvement in visual acuity and refractive errors and endothelial cell loss were similar.

Source: https://journals.lww.com/corneajrnl/Abstract/9000/Effect_of_Previous_Crosslinking_on_Intraoperative.95741.aspx
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