A new surgical technique for deep lamellar keratoplasty with single running suture adjustment.
OBJECTIVE
To improve the technique of deep lamellar keratoplasty.


METHODS
For the recipient eye, a divide-and-conquer technique was applied to deep lamellar keratoplasty. After trephinization, the recipient cornea within the trephine was divided into four quadrants to facilitate lamellar dissection at approximately 70% depth. This procedure of division was continued until the Descemet membrane was exposed in the central area. The corneal graft was placed with an adjusted single running suture. Seventeen eyes were treated with this technique.


RESULTS
In 17 eyes of 15 patients, the mean visual acuity 6 months or more after deep lamellar keratoplasty was 20/52 with eyeglass correction and 20/80 without eyeglass correction. At 6 months or more after deep lamellar keratoplasty, the mean +/- SD keratometric astigmatism in 17 eyes was 3.2 +/- 2.3 diopters.


CONCLUSIONS
This technique facilitates deep lamellar keratoplasty and prevents high or excessive astigmatism after surgery.
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. kazuo@eyebank.or.jp
K
K
Tsubota
M
M
Kaido
Y
Y
Monden
Y
Y
Satake
H
H
Bissen-Miyajima
J
J
Shimazaki
D001251:Astigmatism / Q000517:prevention & control; D003316:Corneal Diseases / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013536:Suture Techniques; D014792:Visual Acuity