Central Lamellar Keratoplasty for Optical Indications

Abstract

Although LKP provides a safer alternative to penetrating keratoplasty, it is limited by vision-reducing graft-host interface problems, astigmatism, and difficult surgical technique. We postulate that the current results of LKP may be improved by (1) removing as much recipient corneal stroma as possible (e.g., dissecting down to Descemet's membrane) or, alternatively, using an automated microkeratome and (2) raising the currently used qualitative eyebank standards for accepting LKP donor tissue.

Intralamellar haemorrhage 44 years following lamellar keratoplasty

“…Neovascularisation of the graft surface or interface is a recognised complication of lamellar keratoplasty, which may be associated with opacification. 8 However, to the best of our knowledge, such sudden and extensive haemorrhage from these vessels has not been reported previously. The patient's use of clopidogrel, which impairs platelet aggregation and thrombus formation, could have been a contributory factor to his presentation.…”

“…[6][7][8] Some of these have been addressed by modern advancements in lamellar surgery, namely deep lamellar Correspondence keratoplasty (DLK) and Deep Lamellar Endothelial Keratoplasty (DLEK). Neovascularisation of the graft surface or interface is a recognised complication of lamellar keratoplasty, which may be associated with opacification.…”

Deep Anterior Lamellar Keratoplasty for Ectatic Disease

“…They noted that problems at the interface limited the results and suggested maximum stroma removal to achieve the best possible visual acuity. 83 Han et al studied only patients with keratoconus who underwent the modified Anwar Tan DALK or PK procedure and found that 1 year later, 64.3% of the DALK patients and 67% of the PK patients achieved a BSCVA of 20/20. This study included one pre-Descemetic technique, but superior results were obtained with Descemetic techniques.…”

Diamond burr superficial keratectomy in the treatment of visually-significant anterior corneal lesions

“…Excimer laser phototherapeutic keratectomy (PTK), for instance, is used for the treatment of a variety of superficial corneal disorders, such as recurrent corneal erosions and the removal of anterior corneal opacities (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) . The main drawbacks of PTK are their high cost and the postoperative refractive shifts towards hyperopia (3)(4) .…”