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Chapter-17 Deep Anterior Lamellar Keratoplasty with Vacuumdried Corneal Tissue: A Versatile Approach

BOOK TITLE: Surgical Techniques in Anterior and Posterior Lamellar Corneal Surgery

Author
1. Rostron Chad K
ISBN
9788180616051
DOI
10.5005/jp/books/10883_17
Edition
1/e
Publishing Year
2006
Pages
11
Author Affiliations
1. Moorefields Eye Hospital, London, England, St George’s Hospital, London, England
Chapter keywords

Abstract

There is now a profusion of different techniques with which to accomplish anterior lamellar keratoplasty (ALKP). Where is the trade-off between the difficulty and complexity of learning several techniques, against the benefit of having extensive experience with a single approach? One answer to this question may well be the femtosecond intrastromal laser, used to cut both the donor button and recipient bed; but for many ophthalmologists, performance of the procedure using manual surgical skills is likely to remain a necessity for some time to come. Resection of a deep lamella of anterior stromal tissue can be achieved by a number of different approaches including controlled depth trephination, interlamellar dissection techniques, or an open direct approach as described in this chapter. However, if maximal-depth complete stromal resection is desired, then some combination of air, hydro- and viscodissection facilitates definition of the pre-Descemet’s plane. This chapter was based on the paper: Rostron CK. Deep Anterior Lamellar Keratoplasty (DALK)—a versatile approach. Asoc Am Oftalmol Optom 2004, and Figure 17.3 was reproduced from Coombes AGA, Kirwan JF, Rostron CK. Deep lamellar keratoplasty with lyophilized tissue in the management of keratoconus. Br J Ophthalmol 2001;85:788–91, with the permission of the publishers.

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