PURPOSE: To describe a technique for sutureless, posterior lamellar keratoplasty. METHODS: The procedure was performed for a case of pseudophakic bullous keratopathy. Through a 5.0-mm, self-sealing scleral tunnel incision, a stromal pocket was dissected across the cornea, just above Descemet's membrane. An 8.5-mm diameter posterior lamellar disc, consisting of posterior stroma, Descemet's membrane, and endothelium, was transplanted without suture fixation. RESULTS: One week after surgery, the best spectacle corrected visual acuity (BSCVA) was 0.8 (20/25), with S -1.5 and C -1.0 x 85 degrees. After 1 year, the posterior transplant was clear and in position, and the BSCVA was 0.8 with S -1.5 and C -1.75 x 80 degrees. Pachymetry measured 0.60 mm. Endothelial cell counts averaged 1390 cells/mm2. CONCLUSION: Sutureless, posterior lamellar keratoplasty may be an effective new surgical approach for managing corneal endothelial disorders.
PURPOSE: To describe a technique for sutureless, posterior lamellar keratoplasty. METHODS: The procedure was performed for a case of pseudophakic bullous keratopathy. Through a 5.0-mm, self-sealing scleral tunnel incision, a stromal pocket was dissected across the cornea, just above Descemet's membrane. An 8.5-mm diameter posterior lamellar disc, consisting of posterior stroma, Descemet's membrane, and endothelium, was transplanted without suture fixation. RESULTS: One week after surgery, the best spectacle corrected visual acuity (BSCVA) was 0.8 (20/25), with S -1.5 and C -1.0 x 85 degrees. After 1 year, the posterior transplant was clear and in position, and the BSCVA was 0.8 with S -1.5 and C -1.75 x 80 degrees. Pachymetry measured 0.60 mm. Endothelial cell counts averaged 1390 cells/mm2. CONCLUSION: Sutureless, posterior lamellar keratoplasty may be an effective new surgical approach for managing corneal endothelial disorders.
Authors: Carla P Nieuwendaal; Ivanka J E van der Meulen; Ruth Lapid-Gortzak; Maarten P Mourits Journal: Int Ophthalmol Date: 2012-11-06 Impact factor: 2.031