Deep anterior lamellar keratoplasty with phacoemulsification

Panda, Anita; Sethi, Harinder Singh; Jain, Mohit; Krishna, Sasikala Nindra; Gupta, Avantika

doi:10.1016/j.jcrs.2010.07.031

Cited by 25 publications

(24 citation statements)

References 15 publications

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“…1 The triple procedure has an increased risk of extension of capsulorhexis, posterior capsular tear and vitreous loss. 1,2 The sequential approach subjects the patient to multiple operations and anaesthesia with delayed rehabilitation. 1,2 DALK is the gold standard approach for anterior corneal pathology in eyes with a healthy endothelium as it eliminates the possibility of endothelial rejection and consequent graft failure.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The sequential approach subjects the patient to multiple operations and anaesthesia with delayed rehabilitation. 1,2 DALK is the gold standard approach for anterior corneal pathology in eyes with a healthy endothelium as it eliminates the possibility of endothelial rejection and consequent graft failure. 3 It is essentially an extraocular procedure which allows for faster rehabilitation and a stronger eye.…”

Section: Introductionmentioning

confidence: 99%

“…These include lamellar stromal dissection, cataract extraction and completion of stromal dissection 3 or Descemet's membrane (DM) baring and cataract extraction followed by sewing on the donor button. 2,4 Dua et al 5 recently demonstrated a pre-Descemet's layer (Dua's layer (DL)) which was described by the authors to be much tougher and resilient than DM and could withstand a pressure of around 700 mm of Hg. In this report we describe a technique and clinical application that exploits the knowledge of DL and enabled us to perform successful DALK combined with phacoemulsification and implant (DALK triple) by baring DL prior to lens extraction.…”

Section: Introductionmentioning

confidence: 99%

“…In this report we describe a technique and clinical application that exploits the knowledge of DL and enabled us to perform successful DALK combined with phacoemulsification and implant (DALK triple) by baring DL prior to lens extraction. We also attempted to simulate the procedure of phacoemulsification after baring DM as reported by others 2,4 with the complication of DM rupture.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Deep anterior lamellar keratoplasty—triple procedure: a useful clinical application of the pre-Descemet’s layer (Dua’s layer)

Zaki

El‐Alfy

Said

et al. 2014

Eye

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Purpose To describe a technique which exploits the transparency and toughness of the pre-Descemets layer (Dua's layer) to safely perform deep anterior lamellar keratoplasty (DALK) and phacoemulsification at the same time. Methods Three DALK procedures combined with phacoemulsification were performed by the same surgeon using the big-bubble (BB) technique at the Research Institute of Ophthalmology, Cairo, Egypt. In two cases a type-1 BB, baring Dua's layer, was achieved and in one case a type-2 BB, baring the Descemet's membrane (DM), was achieved. The surgeries were video recorded and photo slit-lamp images were taken in the follow-up visits.Results DALK with phacoemulsification and lens implant was carried out in both patients where a type-1 BB was achieved. At a follow up of 18 months (first case) and 6 months (second case), the best corrected vision was 6/12 for each. In the case where a type-2 BB was achieved, the DM ruptured during injection of viscoelastic prior to capsulorhexis. The procedure was converted to a penetrating keratoplasty without phacoemulsification. Conclusion When a type-1 BB is achieved simultaneous DALK and phacoemulsification can be safely accomplished. Dua's layer allows a clear view for performing phacoemulsification with the added benefit of its toughness, which can maintain a stable anterior chamber for cataract surgery. This should not be attempted when a type-2 BB is achieved.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Deep anterior lamellar keratoplasty—triple procedure: a useful clinical application of the pre-Descemet’s layer (Dua’s layer)

Zaki

El‐Alfy

Said

et al. 2014

Eye

View full text Add to dashboard Cite

show abstract

“…3 Similarly, simultaneous deep anterior lamellar keratoplasty (DALK) and phacoemulsification has been recommended for eyes with coexisting corneal stromal pathologies and cataract when the recipient endothelium is viable. 4 However, in eyes with no preexisting lenticular changes, the need for cataract surgery may emerge later.…”

mentioning

confidence: 99%