Abstract:
:In recent years, deep lamellar keratoplasty (DLKP) has become an alternative surgical approach successfully applied to the treatment of opaque cornea with normal endothelial function. However, techniques for performing DLKP are not standardized and have not been perfected compared with penetrating keratoplasty. We developed a technique of stromal hooking and viscoelastic detaching to create a full-bed exposure of Descemet membrane (DM) for DLKP grafting. The surgical procedures include trephining the recipient stroma, exposure of DM by stromal hooking process using a forceps tooth as hook, detaching stroma from DM by injecting viscoelastic between the 2 layers, removing whole stroma around the trephined margin to obtain full-bed exposure of DM, and grafting cryopreserved donor button. Unlike previously reported techniques, our technique does not attempt directly to dissect stroma but to detach the stromal layer from DM by injecting viscoelastic. Using this technique, among 172 eyes we achieved full-bed DLKP in 1 attempt of the procedure in 42 (24.4%) eyes, in 2 attempts in 65 (37.8%) eyes, and in 3 attempts in 45 (26.2%) eyes. Eighteen of 172 (10.5%) eyes had microperforation of DM, but DLKP surgery was nonetheless completed. Two (1.2%) eyes needed conversion to penetrating keratoplasty because of large perforation of DM. We present a detailed illustration of our surgical procedures for performing full-bed DLKP in the hope that it may be of help to ophthalmologists.
journal_name
Corneajournal_title
Corneaauthors
Yao YFdoi
10.1097/ICO.0b013e31817f445fsubject
Has Abstractpub_date
2008-09-01 00:00:00pages
S19-24eissn
0277-3740issn
1536-4798pii
00003226-200809001-00006journal_volume
27 Suppl 1pub_type
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