Aims/background. To describe a surgical technique for posterior lamellar keratoplasty.
Methods. In a series of 16 eyes, through a paracentesis aqueous was exchanged by air, to visualize the air-to-endothelium interface, i.e. the posterior corneal surface. Through a 9.0 mm scleral incision, a deep stromal pocket was created across the cornea, using the air-to-endothelium interface as a reference plane for dissection depth. The anterior chamber was filled with visco-elastic, and a 7.0 or 7.5 mm diameter, posterior corneal disc was excised.
After thoroughly irrigating the recipient bed, a same size donor posterior disc was implanted into the recipient opening, without suture fixation. The scleral incision was sutured. Patients were examined before surgery, and 6, 12, 24 and 36 months after surgery.
In a last series of 5 eyes, a 5.0 mm self-sealing scleral tunnel incision was made, and an 8.5 mm diameter posterior lamellar disc was transplanted, without the use of any sutures.
Results.
|
6 months |
12 months |
| BCVA |
0.25 to 0.8 |
0.25 to 1.0 |
| Astigmatism |
1.8 D ± 0.7 D |
1.5 D ± 0.8 D |
| Pachymetry |
n.d. |
0.49 ± 0.09 mm |
| ECD |
n.d. |
2520 ± 340 cells/mm2 |
Conclusion. Posterior lamellar keratoplasty through a sclero-corneal pocket incision is a feasible surgical approach to manage corneal endothelial disorders.
