Preliminary report of Los Alamos Keratoplasty Techniques.

We have found that intrastromal diathermy heat to the cornea spares the epithelium and endothelium, while preferentially allowing contraction of the midstromal corneal collagen. Extensive animal studies have demonstrated a potentially useful dosage range for primate corneal diathermy. We have initiated cautious preliminary human studies utilizing the Los Alamos Keratoplasty unit in the last 12 months to reshape the corneas of keratoconus patients who were referred for penetrating keratoplasty. The steepest area of the cone may be flattened from 4 to 57 diopters, thereby allowing a return to contact lens use. We recommend the technique of Los Alamos Keratoplasty as an alternative to penetrating keratoplasty in patients who have been successful in contact lens wear, but whose cone progression precludes continued satisfactory fitting. The procedure appears effective in this preliminary study. The eventual safety and long-them efficacy of this experimental keratorefractive surgical technique requires extensive further study.