Abstract
In recent years, deep lamellar keratoplasty (DLKP) has become an alternative surgical approach successfully applied to the treatment of opaque cornea with normal endothelial function. However, techniques for performing DLKP are not standardized and have not been perfected compared with penetrating keratoplasty. We developed a technique of stromal hooking and viscoelastic detaching to create a full-bed exposure of Descemet membrane (DM) for DLKP grafting. The surgical procedures include trephining the recipient stroma, exposure of DM by stromal hooking process using a forceps tooth as hook, detaching stroma from DM by injecting viscoelastic between the 2 layers, removing whole stroma around the trephined margin to obtain full-bed exposure of DM, and grafting cryopreserved donor button. Unlike previously reported techniques, our technique does not attempt directly to dissect stroma but to detach the stromal layer from DM by injecting viscoelastic. Using this technique, among 172 eyes we achieved full-bed DLKP in 1 attempt of the procedure in 42 (24.4%) eyes, in 2 attempts in 65 (37.8%) eyes, and in 3 attempts in 45 (26.2%) eyes. Eighteen of 172 (10.5%) eyes had microperforation of DM, but DLKP surgery was nonetheless completed. Two (1.2%) eyes needed conversion to penetrating keratoplasty because of large perforation of DM. We present a detailed illustration of our surgical procedures for performing full-bed DLKP in the hope that it may be of help to ophthalmologists.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.