[Lamellar keratoplasty - new concepts].
New concepts of lamellar keratoplasty techniques mainly deal with the refinement of the so-called deep lamellar endothelial keratoplasty (DLEK). The aim of the deep lamellar technique is to expose bare Descemet's membrane of the recipient and to suture in a full thickness graft. Graft rejections are not known with DLEK. We describe the preparation techniques of Anwar, Melles, and Krumeich and discuss the advantages and disadvantages. The femtosecond laser enables the surgeon to cut the cornea non-mechanically with a cutting accuracy of +/- 10 microns. Fuchs endothelial dystrophy can be treated by posterior lamellar keratoplasty (POLK). In this technique only a sheet of Descemet's and endothelium are replaced. In severe alkali burn with limbal stem cell deficiency a lamellar corneo-scleral disc can be grafted in order to restore the limbus. Routine central penetrating keratoplasty should follow at least half a year later.
Duncker
Gernot I W
GI
Universitätsklinik und Poliklinik für Augenheilkunde der Martin-Luther-Universität Halle-Wittenberg. gernot.duncker@medizin.uni-halle.de
Krumeich
Jörg
J
Wilhelm
Frank
F
Bredehorn
Timm
T
D016039:Corneal Transplantation / Q000295:instrumentation*; D003886:Descemet Membrane / Q000601:surgery; D004728:Endothelium, Corneal / Q000601:surgery; D004867:Equipment Design; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation; D011183:Postoperative Complications / Q000209:etiology; D013525:Surgical Instruments; D013536:Suture Techniques