Preliminary clinical results of posterior lamellar keratoplasty through a sclerocorneal pocket incision.
OBJECTIVE
To report the preliminary results of a surgical technique for transplantation of posterior corneal tissue through a sclerocorneal pocket incision for corneal endothelial disorders.


METHODS
Retrospective, noncomparative, interventional cases series.


METHODS
In seven sighted human eyes, a deep stromal pocket was created across the cornea through a 9.0-mm superior scleral incision. A 7.0- or 7.5-mm diameter, posterior lamellar disc was excised and replaced by a 'same size' donor posterior disc, without suture fixation. The scleral incision was sutured.


METHODS
Intra- and postoperative complications, best spectacle-corrected visual acuity, keratometry, topography, biomicroscopy, pachymetry, and endothelial cell density were evaluated.


RESULTS
Six to 12 months after surgery, all transplants were clear and in position. Best spectacle-corrected visual acuity was limited by preexisting maculopathies in two eyes and varied from 20/80 to 20/20. Postoperative astigmatism averaged 1. 54 diopters (D; standard deviation [SD] +/- 0.81 D), pachymetry averaged 0.49 mm (SD +/- 0.09 mm), and postoperative endothelial cell density averaged 2520 cells/mm(2) (SD +/- 340 cells/mm(2)). In one eye, a microperforation occurred during stromal pocket dissection so that the procedure was converted into a penetrating keratoplasty.


CONCLUSIONS
Posterior lamellar keratoplasty through a sclerocorneal pocket incision is a feasible surgical approach to manage corneal endothelial disorders.
Melles
G R
GR
The Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands. melles@melles.demon.nl
Lander
F
F
van Dooren
B T
BT
Pels
E
E
Beekhuis
W H
WH
D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003317:Corneal Dystrophies, Hereditary / Q000473:pathology / Q000601:surgery; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012590:Sclera / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D014792:Visual Acuity