Dr. ROHIT BANG

Dr.Manasi Bang, Dr. RASHMIN GANDHI, Dr. BHASKAR SRINIVASAN

Abstract

Purpose:DALK has emerged as an option to PK.Aim of this study was to compare the long term graft survival between PK & DALK.Methods:We analysed primary grafts of DALK (n=114) & PK(n=187) performed for optical indications.Primary outcome measure was graft survival time.Kaplan-Meier survival plots were used with Mantel-Cox Log Rank test used to compare survival curves.Results:The 10-year survival rate was 93.9% for DALK&72.0% for PK (p=0.001).Postop complications were higher for PK as compared to DALK like glaucoma(29.3% vs 11.6%), allograft rejection(16.6% vs1.7%,) & epithelial problems(10.4%vs5.5%).The rate of graft failure attributable to rejection (36.7% vs 5.9%) and endothelial failure (36.7% vs 5.9%) were lower in DALK compared to PK.Conclusions:10yrs graft survival for primary DALK was superior to that of PK. Primary DALK results in significantly less postop complications & lower rates of graft rejection.Study strengthens the case in favour of performing DALK over PK when possible

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