skip to main content
Ngôn ngữ:
Giới hạn tìm kiếm: Giới hạn tìm kiếm: Dạng tài nguyên Hiển thị kết quả với: Hiển thị kết quả với: Chỉ mục

Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus

Keane, Miriam ; Coster, Douglas ; Ziaei, Mohammed ; Williams, Keryn

The Cochrane database of systematic reviews, 22 July 2014(7), pp.CD009700 [Tạp chí có phản biện]

E-ISSN: 1469-493X ; PMID: 25055058 Version:1 ; DOI: 10.1002/14651858.CD009700.pub2

Truy cập trực tuyến

Phiên bản sẵn có
Trích dẫn Trích dẫn bởi
  • Nhan đề:
    Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus
  • Tác giả: Keane, Miriam ; Coster, Douglas ; Ziaei, Mohammed ; Williams, Keryn
  • Chủ đề: Corneal Transplantation -- Methods ; Keratoconus -- Surgery ; Keratoplasty, Penetrating -- Methods
  • Là 1 phần của: The Cochrane database of systematic reviews, 22 July 2014(7), pp.CD009700
  • Mô tả: Keratoconus is an ectatic (weakening) disease of the cornea, which is the clear surface at the front of the eye. Approximately 10% to 15% of patients diagnosed with keratoconus require corneal transplantation. This may be full-thickness (penetrating) or partial-thickness (lamellar). To compare visual outcomes after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty for keratoconus, and to compare additional outcomes relating to factors which may contribute to poor visual outcomes (e.g. astigmatism, graft rejection and failure). We searched a number of electronic databases including CENTRAL, PubMed and EMBASE without using any date or language restrictions. We last searched the electronic databases on 31 October 2013. We also handsearched the proceedings of several international ophthalmic conferences. We included all randomised controlled trials (RCTs) comparing the outcomes of DALK and penetrating keratoplasty in the treatment of keratoconus. Two authors assessed trial quality and extracted data independently. For dichotomous data (graft failure, rejection, achievement of functional vision) results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). For continuous data (postoperative best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), keratometric astigmatism and spherical equivalent) results were expressed as mean differences (MDs) and 95% CIs. We identified two completed studies, with a total of 111 participants (n = 30 and n = 81), both conducted in Iran, that met our inclusion criteria. Participants had moderate to severe keratoconus pre-operatively and were randomly allocated to receive either DALK or penetrating keratoplasty. Only one eye of each participant was treated as part of the trials. The smaller study had 12 month follow-up data for all participants. For the larger study, four DALK surgeries had to be abandoned due to technical failure and visual and refractive outcomes were not measured in these participants. Follow-up length for the remaining 77 participants ranged from 6.8 to 36.4 months, with all 77 followed for at least three months post-suture removal. Details of the randomisation procedure were unavailable for the smaller study and so sensitivity analyses were conducted to determine if the results from this study had affected the overall results of the review.Neither of the included studies reported a difference... We found no evidence to support a difference in outcomes with regards to BCVA at three months post-graft or at any of the other time points analysed (GRADE rating: very low). We also found no evidence of a difference in outcomes with regards to graft survival, final UCVA or keratometric outcomes. We found some evidence that rejection is more likely to occur following penetrating keratoplasty than DALK (GRADE rating: moderate). The small number of studies included in the review and methodological issues relating to the two, mean that the overall quality of the evidence in this review is low. There is currently insufficient evidence to determine which technique may offer better overall outcomes - final visual acuity and time to attain this, keratometric stabilisation, risk of rejection or failure, or both, and risk of other adverse events - for patients with keratoconus. Large randomised trials comparing the outcomes of penetrating keratoplasty and DALK in the treatment of keratoconus are...
  • Ngôn ngữ: English
  • Số nhận dạng: E-ISSN: 1469-493X ; PMID: 25055058 Version:1 ; DOI: 10.1002/14651858.CD009700.pub2

Đang tìm Cơ sở dữ liệu bên ngoài...