deep anterior lamellar keratoplasty in keratoconic patients with versus without vernal keratoconjunctivitis

purpose: to compare the clinical outcomes following deep anterior lamellar keratoplasty (dalk) for keratoconic patients with vernal keratoconjunctivitis (vkc) and without vkc. methods: in this retrospective comparative study, the records for 262 eyes with keratoconus only (group 1) and 28 keratoconic eyes with vkc (group 2) that underwent dalk were complied. the parameters reviewed included the length of follow-up, best-corrected visual acuity (bcva), refractive error, complications and cumulative graft survival. results: the mean length of follow-up was 38.6±20.2 months in group 1 and 34.4±20.9 months in group 2 (p=0.21). the mean postoperative bcva was 0.19±0.11 logmar and 0.20±0.15 logmar (p=0.79), with a bscva ≥ 20/40 achieved in 91.6% and 88.5% of these eyes, respectively (p=0.48). epithelial problems were encountered in 31.3% and 42.9% of the eyes, respectively (p=0.16). vascularization of suture tracts and stitch abscesses were encountered more frequently in the eyes with vkc (p=0.01 and <0.001, respectively.) at the 33-month follow-up examination, the rejection-free graft survival rates were 56.0% in group 1 and 33.3% in group 2, with mean durations of 41.0 and 32.1 months, respectively (p=0.15). the graft survival rates were 98.1% in group 1 and 95.0% in group 2, with mean durations of 88.6 and 88.4 months, respectively (p=0.74). conclusion: the clinical outcomes of dalk for the eyes with keratoconus and vkc were comparable to those for the eyes with keratoconus alone. however, because complications such as suture tract vascularization and stitch abscesses were more common when vkc coexisted, closer monitoring is necessary in these cases.