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Netherlands Institute for Innovative Ocular Surgery
Research and development of ophthalmic surgical techniques
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H.A Maaskantstraat 31, 3071 MJ Rotterdam, The Netherlands
tel +31 (0)10 485 4882, fax +31 (0)10 485 2419

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    Deep anterior lamellar keratoplasty (DALK): on-line course
       Abstract
       Chapter 1: Introduction
       Chapter 2: Optical visualization of dissection depth during surgery
       Chapter 3: A strategy to minimize interface haze
       Chapter 4: Manual deep stromal dissection through scleral incision
       Chapter 5: Visco-dissection of Descemets membrane from stroma
       Chapter 6: Preparation of donor tissue
       Chapter 7: Suturing technique
       Chapter 8: Peri-operative topical and systemic therapy
       Chapter 9: Rigid Gas Permeable contact lens fitting
       Chapter 10: Clinical Results
       Chapter 11: Conclusions and recommendations
       References
 Surgical training
 Products and instruments


Chapter 8: Perioperative topical and systemic therapy

A standard therapy regiment for penetrating keratoplasty patients is gentamycin ointment at the evening before surgery, and after surgery chloramphenicol 0.5% three times daily for one month, and dexamethasone 0.1% six times daily for one month, tapering to one time daily at one year. In our series of deep anterior lamellar keratoplasty patients, the same perioperative therapy regiment was followed. Steroid therapy may be tapered sooner, because the risk of endothelial allograft rejection is eliminated.

In patients with recurrent herpetic keratitis acyclovir 400 mg three times daily was given for six months or more. When indicated, immunosuppressive therapy was prescribed.