Sutureless, posterior lamellar keratoplasty: a case report of a modified technique.
OBJECTIVE
To describe a technique for sutureless, posterior lamellar keratoplasty.


METHODS
The procedure was performed for a case of pseudophakic bullous keratopathy. Through a 5.0-mm, self-sealing scleral tunnel incision, a stromal pocket was dissected across the cornea, just above Descemet's membrane. An 8.5-mm diameter posterior lamellar disc, consisting of posterior stroma, Descemet's membrane, and endothelium, was transplanted without suture fixation.


RESULTS
One week after surgery, the best spectacle corrected visual acuity (BSCVA) was 0.8 (20/25), with S -1.5 and C -1.0 x 85 degrees. After 1 year, the posterior transplant was clear and in position, and the BSCVA was 0.8 with S -1.5 and C -1.75 x 80 degrees. Pachymetry measured 0.60 mm. Endothelial cell counts averaged 1390 cells/mm2.


CONCLUSIONS
Sutureless, posterior lamellar keratoplasty may be an effective new surgical approach for managing corneal endothelial disorders.
Melles
Gerrit R J
GR
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands. melles@niioc.nl
Lander
Frank
F
Nieuwendaal
Carla
C
D003316:Corneal Diseases / Q000601:surgery; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013524:Surgical Flaps; D013536:Suture Techniques; D014792:Visual Acuity