New Surgical Techniques of Microkeratome and Excimer Laser-assisted Anterior Lamellar Keratoplasty for Keratoconus and Corneal Stromal Opacities: (1) Stromal Sandwich, (2) Epikeratoplasty

2006 ◽  
pp. 235-235
Author(s):  
Kamil Bïlgïhan ◽  
Sengül Özdek ◽  
Ayça Sari ◽  
Berati Hansanreïsoglu
Keyword(s):  
Excimer Laser ◽  
Surgical Techniques ◽  
Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty

Sutureless superficial anterior lamellar keratoplasty for recurrent corneal haze after repeat excimer laser surface ablation

2019 ◽  
Vol 104 (3) ◽  
pp. 341-344 ◽  
Author(s):  
James Myerscough ◽  
Cristina Bovone ◽  
Peter Benjamin Michael Thomas ◽  
Michael Mimouni ◽  
Faisal Aljassar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Intraoperative Complications ◽  
Lamellar Keratoplasty ◽  
Corneal Haze ◽  
Surface Ablation ◽  
Anterior Lamellar Keratoplasty ◽  
Significant Difference ◽  
Significant Change ◽  
Change In Mean

Background/AimsTo evaluate the 5-year outcomes of sutureless superficial anterior lamellar keratoplasty (SALK) in the treatment of surface ablation-related corneal haze recurring after phototherapeutic keratectomy (PTK).MethodsProspective interventional study at a tertiary referral centre in Forli, Italy. Ten consecutive eyes with corneal haze following photorefractive keratectomy, recurring after treatment with PTK with or without mitomycin C, undergoing sutureless SALK. Sutureless SALK was performed using a microkeratome in donor and recipient. Main outcome measures: best spectacle-corrected visual acuity (BSCVA), surgically induced astigmatism (SIA), rate of recurrence and complications.ResultsThere were no intraoperative complications and there was no recurrence of haze in any eye postoperatively. BSCVA showed significant improvement at all postoperative time points. Mean preoperative visual acuity improved from 0.46 logMAR units (SD=0.12) to 0.12 (SD=0.12, p=0.0001) at 5 years. At 6 months, SIA was 2.50±1.04 with no further significant change at 5 years (2.53±1.39, p=0.95). There was no significant change in mean spherical equivalent and no significant difference between preoperative and postoperative astigmatism vector values at 5 years.ConclusionsSutureless SALK provides a useful treatment option in patients with recurrent haze after excimer laser treatment. It can eliminate haze recurrence for at least a period of 5 years and can improve BSCVA, although there may be significant SIA.

Corneal graft surgery: A monocentric long-term analysis

2020 ◽  
pp. 112067212094759
Author(s):  
Andrea Montesel ◽  
Jorge L Alió del Barrio ◽  
Pilar Yébana Rubio ◽  
Jorge L Alió
Keyword(s):  
Survival Rates ◽  
Surgical Techniques ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Corneal Transplant ◽  
Inclusion Criteria ◽  
Visual Outcomes ◽  
Anterior Lamellar Keratoplasty ◽  
Immunological Rejection ◽  
Clinical Records

Purpose: To investigate indications, outcomes and changes in clinical patterns of keratoplasty surgery in a Spanish tertiary eye center. Setting: Vissum Instituto Oftalmológico, Alicante, Spain. Methods: A retrospective review was performed on clinical records of patients that underwent any kind of corneal transplant from 2001 to 2017 in the study center. Inclusion criteria involved the presence of detailed preoperative examination, surgical report and at least 12 months follow-up after the surgery. A statistical analysis was performed on the indications for keratoplasty, survival rates, type of graft failures, and visual outcomes. Results: A total of 907 keratoplasties procedures were identified. About 432 penetrating keratoplasty (PK), 148 deep anterior lamellar keratoplasty (DALK), and 134 endothelial keratoplasty (EK) met the inclusion criteria. Cumulative survival rate ranged from 94% to 69% in a 1-year period and from 85% to 45% in a 5-years period according to the different graft types. The main cause for failure was immunological rejection for PK, surface diseases for DALK and primary graft failure for EK. Postoperative visual function improved for all the surgical techniques. Conclusion: Corneal transplant is a challenging surgery still complicated by a relevant risk of failure. Our study offers a useful opinion of the current trends on keratoplasty in our country, where the outcomes of the grafts differ considerably in relation to the indications and the different surgical techniques, with lamellar procedures that showed higher rates of success and better visual outcomes than full-thickness grafts.

scholarly journals Peripheral Ulcerative Keratitis in a Patient with Bilateral Scleritis: Medical and Surgical Management

2020 ◽  
Vol 11 (3) ◽  
pp. 500-506
Author(s):  
June Artaechevarria Artieda ◽  
Nuria Estébanez-Corrales ◽  
Olga Sánchez-Pernaute ◽  
Nicolás Alejandre-Alba
Keyword(s):  
Oral Prednisone ◽  
Previous History ◽  
Surgical Techniques ◽  
Lamellar Keratoplasty ◽  
Systemic Autoimmune Disease ◽  
Negative Results ◽  
Peripheral Ulcerative Keratitis ◽  
Anterior Lamellar Keratoplasty ◽  
Ulcerative Keratitis ◽  
Corneal Thinning

Peripheral ulcerative keratitis (PUK) is a group of corneal disorders that cause peripheral corneal thinning, threatening globe integrity in advance stages. It is usually associated with systemic autoimmune diseases and management is based on local and systemic approaches. We present the case of a 47-year-old man with a previous history of bacterial keratitis in his left eye presenting with 1 month of bilateral ocular pain and redness. At examination, diffuse bilateral globe inflammation with paracentral corneal thinning in his left eye was observed. He was diagnosed with bilateral scleritis and PUK in his left eye. Workup for associated systemic autoimmune disease yielded negative results. The patient was started on pulses of intravenous methylprednisolone followed by oral prednisone failing to achieve sufficient control of the inflammatory syndrome. Subsequently, periodic intravenous cyclophosphamide was administered with a favorable response. A multilayer amniotic membrane graft was applied, but there was rapid melting with reabsorption of the tissue, resulting in extreme corneal thinning at the inferior paracentral cornea. A decentered 8.5-mm superficial anterior lamellar keratoplasty (SALK) was then performed obtaining the donor graft with a femtosecond laser but performing manual trepanation in the recipient. At 12 months, visual and biomicroscopic measures do not show deterioration and inflammation remains under control with oral azathioprine as maintenance regime. The management of PUK includes both systemic immunosuppression and tectonic procedures to preserve the globe integrity. Diverse surgical techniques have been attempted, but no definitive guidelines are available. Decentered large SALK is a simple technique that can yield acceptable visual results.

scholarly journals Deep Anterior Lamellar Keratoplasty for Ectatic Disease

2013 ◽  
Vol 2 (1) ◽  
pp. 20-27
Author(s):  
Isaac Ramos ◽  
Paulo Schor ◽  
Allan Luz ◽  
Luciene Babosa ◽  
Bruno Machado Fontes
Keyword(s):  
Survival Rate ◽  
Penetrating Keratoplasty ◽  
Surgical Techniques ◽  
Cost Benefit ◽  
Viable Alternative ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty ◽  
Cause Of Failure ◽  
Visual Results

ABSTRACT Recently, deep anterior lamellar keratoplasty (DALK) has received attention for patients with ectatic diseases not affecting the endothelium. However, it was not always so. For years, DALK was overlooked due to the difficulty in achieving good visual results, which were considered weak in comparison with the results of penetrating keratoplasty (PK). DALK was proposed to retain a patient's healthy endothelium; thereby avoiding some possible complications of PK. Preservation of the endothelium contributes to prolonged survival of the button and thus overcomes a major cause of failure after PK. DALK is now accepted as a viable alternative to PK. With advances in surgical techniques, instruments, and imaging technologies, visual results obtained with lamellar keratoplasty are equivalent to visual outcomes with PK, in addition to providing a transplant cost benefit owing to a better transplantation survival rate. How to cite this article Luz A, Babosa L, Fontes BM, Ramos I, Schor P, Ambrósio R Jr. Deep Anterior Lamellar Keratoplasty for Ectatic Disease. Int J Kerat Ect Cor Dis 2013;2(1):20-27.

scholarly journals Corneal transplantation for keratoconus

2013 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Sven Jonuscheit ◽  
Michael J Doughty
Keyword(s):  
Corneal Transplantation ◽  
Surgical Techniques ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Corneal Transplant ◽  
Eye Care ◽  
Primary Eye Care ◽  
Transplant Centre ◽  
Anterior Lamellar Keratoplasty

This review discusses current techniques of corneal transplantation for moderate to advanced keratoconus. The aim of this article is to provide primary eye care practitioners with an overview of two current corneal transplantation modalities, namely penetrating and deep anterior lamellar keratoplasty. The main surgical techniques, the outcome of the procedures, common complications and the prognosis will be reviewed. Results from ongoing studies at a corneal transplant centre in Glasgow, Scotland will be discussed. 

Sign in / Sign up

Export Citation Format

Share Document