Deep anterior lamellar keratoplasty: dissection plane with viscoelastic and air can be different

Ross, Andrew R.; Said, Dalia G.; El-Amin, Abdalla; AlTaan, S L; Cabrerizo, Javier; Nubile, Mario; Hogan, Emily; Mastropasqua, Leonardo; Dua, Harminder S.

doi:10.1136/bjophthalmol-2017-311349

Cited by 11 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it has been recently shown that unlike with air injection, the plane of insertion of the needle tip is crucial, because with mid stroma injections of viscoelastic, an intrastromal bubble, mimicking a Type-1 BB, often occurs. [ 53 ]…”

Section: Deep Anterior Lamellar Keratoplastymentioning

confidence: 99%

Lamellar keratoplasty techniques

Singh

Said

Dua

2018

Indian J Ophthalmol

View full text Add to dashboard Cite

Lamellar keratoplasty (LK) has revolutionized corneal graft surgery in several ways. Deep anterior LK (DALK) has eliminated risk of failure due to endothelial rejection. Endothelial keratoplasty (EK) has almost eliminated induced astigmatism and the “weak” graft–host junction as seen with penetrating keratoplasty (PK) and also reduced the risk of endothelial rejection. LK provided new insights into posterior corneal anatomy that led to better understanding and performance of DALK and to the development of another EK procedure, namely pre-Descemet's EK (PDEK). Surgical procedures for LK were further refined based on the improved understanding and are able to deliver better surgical outcomes in terms of structural integrity and long-term patient satisfaction, reducing the need of further surgeries and minimizing patient discomfort. In most specialist centers, anterior lamellar techniques like DALK and EK techniques like Descemet's stripping EK (DSEK) and Descemet's membrane EK (DMEK) have replaced the full-thickness PK where possible. The introduction of microkeratome, femtosecond laser, and PDEK clamp have made LK techniques easier and more predictable and have led to the innovation of another LK procedure, namely Bowman membrane transplant (BMT). In this article, we discuss the evolution of different surgical techniques, their principles, main outcomes, and limitations. To date, experience with BMT is limited, but DALK has become the gold standard for anterior LK. The EK procedures too have undergone a rapid transition from DSEK to DMEK and PDEK emerging as a viable option. Ultrathin-DSEK may still have a role in modern EK.

show abstract

Section: Deep Anterior Lamellar Keratoplastymentioning

confidence: 99%

Lamellar keratoplasty techniques

Singh

Said

Dua

2018

Indian J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…Recipient beds were trephinated using 3.0-6.0 mm skin biopsy punches (Stiefel Laboratories, Inc., Middlesex, United Kingdom) or using 7.0-8.0 mm diameter vacuum trephine and vacuum donor punch (Moria, Antony, France) along the size and location of underlying lesions. For DALK, the big bubble technique or viscodissection was used for recipient bed preparation 17 . For elongated lesions that could not be grafted with commercially available punches or trephine, such as Terrien marginal degeneration or marginal keratitis, recipient lesions were manually resected using a no.…”

mentioning

confidence: 99%

Therapeutic and Tectonic Keratoplasty with Simple Cryopreserved Remnants of Donor Corneas: An 11 Year Retrospective Case Series

Kim

Jun

2021

Preprint

View full text Add to dashboard Cite

This study sought to describe the use of deep-frozen donor corneal remnants preserved after keratoplasty procedures for therapeutic or tectonic keratoplasty without subsequent optical keratoplasty. This single-centre retrospective consecutive case series analyzed the electronic medical records of patients who had undergone therapeutic or tectonic keratoplasty using deep-frozen donor remains preserved in Optisol-GS, for the past 11 years at Keimyung University Dongsan Medical Center. Fifty-five surgical cases in 46 patients were included. Twenty-three surgical cases in 18 patients underwent therapeutic keratoplasty for refractory infectious corneal ulcer. Complete eradiation of primary infection was achieved in 14 patients (77.8%). Tectonic keratoplasty were performed 32 cases in 28 patients. Twenty-seven of 28 patients were ultimately able to maintain anatomical integrity (96.4%). Mean uncorrected visual acuity improved from 1.77 ± 0.94 preoperatively to 1.31 ± 0.95 at the last follow up postoperatively in the tectonic graft group by logarithm of the minimal angle of resolution (P = 0.002). There were no cases of graft rejection. Keratoplasty using cryopreserved donor tissue is a suitable surgical alternative for infectious or non-infectious corneal ulcers in elderly patients or patients with poor general condition. It could be a viable alternative to overcome the shortage of corneal donors.

show abstract

Keratoconus and Corneal Noninflammatory Ectasias

Albè

2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

View full text Add to dashboard Cite

Deep anterior lamellar keratoplasty: dissection plane with viscoelastic and air can be different

Cited by 11 publications

References 25 publications

Lamellar keratoplasty techniques

Lamellar keratoplasty techniques

Therapeutic and Tectonic Keratoplasty with Simple Cryopreserved Remnants of Donor Corneas: An 11 Year Retrospective Case Series

Keratoconus and Corneal Noninflammatory Ectasias

Contact Info

Product

Resources

About