title: Fluid lamellar keratoplasty in keratoconus.
abstract: OBJECTIVE
  The authors evaluated the efficacy of the modified technique of fluid deep lamellar keratoplasty in keratoconus.
  
  
  METHODS
  Noncomparative case series.
  
  
  METHODS
  Twenty-six eyes of 25 patients with moderate to advanced keratoconus were included. Fourteen males and 11 females with age range of 16 to 37 years.
  
  
  METHODS
  Deep lamellar keratoplasty aided by intrastromal injection of balanced salt solution to facilitate corneal dissection down to Descemet's membrane. Full-thickness graft devoid of endothelium and Descemet's membrane was then sutured in place.
  
  
  METHODS
  Spectacle-corrected visual acuity, slit-lamp biomicroscopy, corneal topography, and ocular tension.
  
  
  RESULTS
  Two cases (8.4%) were converted to penetrating keratoplasty because of intraoperative perforation. Of the 24 successful cases, 19 eyes (79%) achieved >20/50 at 3 months and 21 (87.5%) achieved >20/40 at 6 months. Twenty-three eyes (95.8%) were 20/30 or better 1 year after suture removal. Only one eye (4.2%) had interface irregular astigmatism corrected by contact lens to 20/40.
  
  
  CONCLUSIONS
  Fluid deep lamellar keratoplasty is a safe and effective procedure, especially in bilateral keratoconus, because it has no rejection complication. However, it is technically difficult with slow visual rehabilitation.
authors.affiliation: El-Maghraby Eye Center, Jeddah, Saudi Arabia.
authors.forename: A F
authors.initials: AF
authors.lastname: Amayem
authors.forename: M
authors.initials: M
authors.lastname: Anwar
mesh_terms: D000293:Adolescent; D000328:Adult; D003261:Contact Lenses; D003315:Cornea / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007552:Isotonic Solutions; D007640:Keratoconus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D014792:Visual Acuity
chemical_list: D007552:Isotonic Solutions