[Preliminary clinical results of optical lamellar keratoplasty assisted by homemade-microkeratome].
OBJECTIVE
To evaluate the efficacy and safety of optical lamellar keratoplasty assisted by homemade-microkeratome in treating corneal opacification for optical indications.


METHODS
In 12 eyes of 11 patients with corneal opacities and healthy endothelium, the homemade-microkeratome was used for the resection of corneal opacities whose depth measured by optical pachymeter preoperatively, and the donor disc was excised by the same technique. After the resection of corneal opacities, the residual bed thickness was measured by ultrasonopachymeter. The disparities in thickness and diameter between the bed and the donor disc were reduced as least as possible by the use of different suction rings and microkeratome heads. The donor disc was secured with four or eight interrupted sutures. The period of follow-up ranged from 7 to 14 months. The transparency of cornea, donor-host interface and the refractive changes after surgery were examined by slit-lamp microscopy and Keratron videokeratoscope.


RESULTS
The slit-lamp microscopic examination showed no severe complications after surgery, all grafts appeared to be transparent without recognizable opacity in the interface except 1 eye with epithelial ingrowth and local graft melting subsequently. Visual acuities were improved in all eyes, 7 eyes had best corrected visual acuity better than 0.5 and 2 eyes reached 0.8. During the follow-up 3 to 6 months, the mean corneal refractive power significantly increased (2.36 +/- 1.25) D (P = 0.016), and the corneal astigmatism significantly decreased (0.97 +/- 0.95) D (P = 0.023) Compared with that before surgery, the increase of the corneal refractive power had negative correlation with the thickness of residual bed (r = -0.830, P = 0.004).


CONCLUSIONS
This easy, safe new technique leads to good visual results and represents a good alternative to penetrating keratoplasty in treating corneal opacities.
Chen
Wei
W
The Affiliated Eye Hospital of Wenzhou Medical College, Zhejiang 325003, China.
Chu
Ren-yuan
RY
Qu
Jia
J
Wang
Qin-mei
QM
Zhou
Xing-tao
XT
Zhao
Yun-e
YE
D000328:Adult; D003315:Cornea / Q000473:pathology / Q000601:surgery; D003318:Corneal Opacity / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014792:Visual Acuity