scholarly journals Lamellar Keratoplasty: A Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Ladan Espandar ◽  
Alan N. Carlson
Keyword(s):  
Literature Review ◽  
Graft Rejection ◽  
Corneal Stroma ◽  
Surgical Instruments ◽  
Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
New Techniques ◽  
Posterior Lamellar Keratoplasty ◽  
Acceptable Alternative ◽  
Anterior Lamellar Keratoplasty

The concept of lamellar keratoplasty (LK) is not new. However, newer forms of lamellar keratoplasty techniques have emerged in the last decade or so revolving around the concept of targeted replacement of diseased corneal layers. These include anterior lamellar keratoplasty (ALK) techniques that aim to selectively replace diseased corneal stroma and endothelial keratoplasty techniques aiming to replaced damaged endothelium in endothelial disorders. Recent improvements in surgical instruments and introduction of new techniques as well as inherent advantages such as preservation of globe integrity and decreased graft rejection have resulted in the reintroduction of LK as an acceptable alternative to conventional PK. In this review, indications, benefits, limitations, and outcomes of various anterior and posterior lamellar keratoplasty techniques are discussed.

Endothelial Keratoplasty: Yesterday and Today (literature review)

2021 ◽  
pp. 91-95
Author(s):  
M.M. Bikbov ◽  
◽  
L.R. Marvanova ◽  
Keyword(s):  
Literature Review ◽  
Corneal Endothelium ◽  
Corneal Transplantation ◽  
Surgical Techniques ◽  
Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Circular Section ◽  
Posterior Lamellar Keratoplasty ◽  
Donor Graft

The article presents the literature review on the history and development of endothelial keratoplasty, which is one of the options for corneal transplantation. It includes different surgical techniques (posterior lamellar keratoplasty, with removal of the a circular section of the Descemet's membrane, deep lamellar endothelial keratoplasty, posterior lamellar keratoplasty (automated), etc.) used for the treatment of patients with pathology of the corneal endothelium and is characterized by replacement of it with corneal back layers of the donor graft. Ophthalmic surgical practice has convincingly shown a significant advantage of modern methods of endothelial keratoplasty in comparison with classical penetrating keratoplasty, which is a long-term standard in the treatment of corneal pathology. Key word: endothelial keratoplasty, the pathology of the corneal endothelium, corneal transplantation, posterior lamellar keratoplasty, deep lamellar endothelial keratoplasty.

Microsporidial Endotheliitis Mimicking Graft Rejection After Deep Anterior Lamellar Keratoplasty

Cornea ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Neha Gandhi ◽  
Sujata Das ◽  
Ruchi Mittal ◽  
Manas R. Barik
Keyword(s):  
Graft Rejection ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty

scholarly journals Approaches toward enhancing survival probability following deep anterior lamellar keratoplasty

2020 ◽  
Vol 12 ◽  
pp. 251584142091301
Author(s):  
Sepehr Feizi ◽  
Amir A Azari
Keyword(s):  
Graft Rejection ◽  
Graft Failure ◽  
Corneal Transplantation ◽  
Corneal Neovascularization ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Vernal Keratoconjunctivitis ◽  
Full Thickness ◽  
Appropriate Treatment ◽  
Anterior Lamellar Keratoplasty

The greatest advantage of deep anterior lamellar keratoplasty over full-thickness corneal transplantation is the elimination of graft failure caused by endothelial rejection. Despite this advantage, a deep anterior lamellar keratoplasty graft can fail because of several factors, such as complications related to the donor–recipient interface, graft epithelial abnormalities, graft vascularization, stromal graft rejection, and recurrence of herpetic keratitis. Increased deep anterior lamellar keratoplasty graft survival is mainly built upon optimization of the ocular surface to provide a hospitable environment for the graft. Any predisposing factors for graft epithelial abnormalities, corneal neovascularization, and preexisting vernal keratoconjunctivitis should be identified and treated preoperatively. Prompt recognition and appropriate treatment of interface-related complications and stromal graft rejection usually result in good anatomic outcomes, with no detrimental effects on vision.

scholarly journals Risk factors influencing survival of acellular porcine corneal stroma in infectious keratitis: a prospective clinical study

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Saiqun Li ◽  
Meng Li ◽  
Li Gu ◽  
Lulu Peng ◽  
Yuqing Deng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Graft Survival ◽  
Graft Failure ◽  
Corneal Stroma ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Infectious Keratitis ◽  
Anterior Lamellar Keratoplasty

Abstract Background A worldwide lack of donor corneas demands the bioengineered corneas be developed as an alternative. The primary objective of the current study was to evaluate the efficacy of acellular porcine corneal stroma (APCS) transplantation in various types of infectious keratitis and identify risk factors that may increase APCS graft failure. Methods In this prospective interventional study, 39 patients with progressive infectious keratitis underwent therapeutic lamellar keratoplasty using APCS and were followed up for 12 months. Data collected for analysis included preoperative characteristics, visual acuity, graft survival and complications. Graft survival was evaluated by the Kaplan–Meier method and compared with the log-rank test. Results The percentage of eyes that had a visual acuity of 20/40 or better increased from 10.3% preoperatively to 51.2% at 12 months postoperatively. Twelve patients (30.8%) experienced graft failure within the follow-up period. The primary reasons given for graft failure was noninfectious graft melting (n = 5), and the other causes included recurrence of primary infection (n = 4) and extensive graft neovascularization (n = 3). No graft rejection was observed during the follow-up period. A higher relative risk (RR) of graft failure was associated with herpetic keratitis (RR = 8.0, P = 0.046) and graft size larger than 8 mm (RR = 6.5, P < 0.001). Conclusions APCS transplantation is an alternative treatment option for eyes with medically unresponsive infectious keratitis. Despite the efficacy of therapeutic lamellar keratoplasty with APCS, to achieve a good prognosis, restriction of surgical indications, careful selection of patients and postoperative management must be emphasized. Trial registration Prospective Study of Deep Anterior Lamellar Keratoplasty Using Acellular Porcine Cornea, NCT03105466. Registered 31 August 2016, ClinicalTrails.gov

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