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Chapter-40 Deep Anterior Lamellar Keratoplasty in Keratoconus

BOOK TITLE: Surgical Techniques in Ophthalmology: Corneal Surgery

Author
1. Malyugin Boris
ISBN
9788184488579
DOI
10.5005/jp/books/11369_40
Edition
1/e
Publishing Year
2010
Pages
12
Author Affiliations
1. Complex State Institution, 127486 Moscow, Beskudnikovsky blvd 59A, Russia, S. Fyodorov Eye Microsurgery, Complex State Institution, 127486 Moscow, Beskudnikovsky blvd 59A, Russia, Dy Director General, S Fyodorov Eye Microsurgery, Complex State Institution, 127486 Moscow, Beskudnikovsky blvd 59A, Russia, S. Fyodorov Eye Microsurgery, Complex State Institution, 127486 Moscow, Beskudnikovsky blvd 59A (Russia), Complex State Institution, 127486 Moscow, Beskudnikovsky, blvd 59A, Russia, S Fyodorov Eye Microsurgery Complex State Institution, Beskudnikovsky blvd 59 A, Moscow, 127486, Russia, S Fyodorov Eye Microsurgery, Complex State Institution, 127486, Moscow, Beskudnikovsky blvd 59A, Russia, S Fyodorov Eye Microsurgery State Institution, Moscow, Russian Federation, S Fyodorov Eye Micerosurgery, Complex State Institution, 127486 Moscow Beskudnikovsky blvd 59A, Russia, S Fyodorov Eye Microsurgery, Complex State Institution, 127486 Moscow, Beskundnikovsky blvd 59A, Russia, S Fyodorov Eye Microsurgery Complex State I
Chapter keywords
Lamellar keratoplasty, corneal endothelial layer, corneal stromal diseases, Descemet’s membrane (DM), optical lamellar keratoplasty procedures, deep lamellar keratoplasty (DLKP), lamellar keratoplasty (LKP), air-visco bubble technique

Abstract

Lamellar keratoplasty is the technique based on preserving the corneal endothelial layer and is indicated for the patients with the corneal stromal diseases. This procedure is very important, especially for the keratoconus patients, who in spite of the high success rate can have 20% chance of endothelial rejection episodes. Exceptions will be the defects and scars involving Descemet’s membrane (DM). There is renewed interest in optical lamellar keratoplasty procedures. In its latest modification—deep lamellar keratoplasty (DLKP) the surgeon reaches Descemet’s membrane. As the result of less regenerative tissue response, better optical clarity than in regular lamellar keratoplasty (LKP) is achieved. Recent technical developments have made DLKP the preferred procedure for patients with healthy DM and corneal endothelium. DLKP is still technically difficult procedure demanding from the surgeon certain level of skill. The use of air-visco bubble technique can be considered a suitable technique. This procedure produces good visual results with low rate of complication.

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