Ozgur A.Ucgul A.Y.Cubuk M.O.Onat E.Ceylanoglu K.S.Aydın B.Yuksel E.2023-04-122023-04-122021-12-0101655701https://hdl.handle.net/20.500.12597/4310Aims: To investigate possible predictive topographic characteristics for the development of Descemet’s membrane (DM) folds after the uneventful deep anterior lamellar keratoplasty (DALK). Methods: A retrospective study included 56 eyes of 56 consecutive patients who underwent uneventful DALK using the big-bubble technique to treat advanced keratoconus. At baseline and each visit, best-corrected logMAR visual acuity (BCVA), slit-lamp findings, endothelial cell density, topographic parameters were recorded. DM area is calculated using morphogeometric modelling. Results: Twelve (21.4%) of them exhibited DM folds, whereas the remaining 44 (78.6%) did not exhibit any DM folds after the surgery. The mean follow-up time was 36.3 ± 16.7 (range, 12–71) months. The mean posterior corneal power was − 13.8 ± 0.6 D in patients with DM folds, whereas − 13.0 ± 0.8 D in those without DM folds (p = 0.016). The mean DM area was 53.6 ± 2.3 (50.9–57.9) mm2 in patients with DM folds, whereas 51.6 ± 1.7 (47.1–53.9) mm2 in those without DM folds (p = 0.001). The ROC curve showed that two best cut-off value for the posterior corneal power and DM area were 13.75 D and 53.8 mm2, respectively, to predict the occurrence of DM folds. Conclusion: DALK surgery seems to cause DM folds in patients with large DM area and high posterior corneal power.falseAdvanced keratoconus | Deep anterior lamellar keratoplasty | Descemet’s membrane area | Descemet’s membrane folds | Posterior corneal powerArticle10.1007/s10792-021-01974-z2-s2.0-8511098851234296350