Endothelial replacement without surface corneal incisions or sutures: topography of the deep lamellar endothelial keratoplasty procedure.
OBJECTIVE
To evaluate the immediate postoperative corneal topography after the deep lamellar endothelial keratoplasty procedure.


METHODS
Eight eye bank eyes underwent deep lamellar endothelial keratoplasty through a 9.0-mm limbal incision replacing the central 7.0 mm of posterior stroma and endothelium through the lamellar pocket wound. Orbscan topography was performed before and after surgery, and simulated keratometry readings and central corneal diopter power were recorded. The change in astigmatism and corneal power from preoperative to postoperative readings was then determined.


RESULTS
The net change in corneal astigmatism averaged 0.4+/-0.5 diopters (range, -0.1 to 1.1 diopters). The net change in corneal power averaged -0.2+/-0.4 diopters of flattening (range, -0.9 to +0.2 diopters). Neither the astigmatism nor the corneal power levels after this surgery were significantly different from the preoperative topography (p = 0.22 and 0.27, respectively).


CONCLUSIONS
The deep lamellar endothelial keratoplasty procedure, with its absence of corneal surface incisions or sutures, has no significant effect on immediate postoperative corneal topography. The potential advantages of this procedure over penetrating keratoplasty in the treatment of endothelial dysfunction are considerable.
Terry
M A
MA
Lions Vision Research Laboratory of Oregon, Portland, USA.
Ousley
P J
PJ
D001251:Astigmatism / Q000473:pathology / Q000601:surgery; D002102:Cadaver; D003315:Cornea / Q000473:pathology; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000295:instrumentation / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology / Q000637:transplantation*; D004867:Equipment Design; D006801:Humans; D066298:In Vitro Techniques; D012029:Refraction, Ocular; D013536:Suture Techniques; D014019:Tissue Donors