الفهرس 
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Abstract
Background: Keratocnus is a progressive eye disease that often begins during a person’s teens or early 20 s. It causes progressive nearsightedness and irregular astigmatism, distorted and blurred vision, glare and light sensitivity also may occur. It is one of the most common corneal diseases that refractive surgeons encounter. In Egypt in a study conducted in Beni-Sueif Egypt incidence was 1.7% this result is combarable to Caucasian people in Asia Eg. Iran but the incidence is higher in malysia and Saudi Arabia. 15 -20%of those with keratoconus ultimately require corneal transplant surgery.
Objective: Comparing the wound configuration and graft apposition after penetrating keratoplasty with wound configuration and graft apposition after deep anterior lamellar keratoplasty using anterior segment optical coherence tomography in keratoconic patients.
Subjects and Methods: Comparative interventional study included 30 eyes with advanced keratoconus patients who underwent femto PKP and femto DALK.
Results: But regarding internal malapposition we found in DALK 80.8% graft host junctions were well apposed compared to 18.3% graft host junctions in pkp group and 19.2%were malapposed compared to and 81.6% mal apposesed junctions in pkp group and the difference between 2 groups was highly significant p-value < 0.001. In pkp there were 4 types of malapposition. The most common form of mal apposition was stepping represent 54.2% from total graft host junctions and the second was protrusion 23 graft host junction 19.2% from the total graft host juctions and. The third was gapping 6.7%juctions and the last was tag 1.7% junctions. We found only 1 type of malapposition protrusion represent 19.2% of the DALK graft host junctions and the difference in protrusion between both groups wasn’t clinically significant but we didn’t find any stepping, gapping so the difference was clinically significant between both groups.
Conclusion: As we found that DALK 97(80.8%) graft host junctions were well apposed compared to22 (18.3%) graft host junctions in pkp group and 23 (19.2%)were malapposed compared to and 98 (81.6%) mal apposesed junctions in pkp group and the difference between 2 groups was highly significant p-value < 0.001.