Air-guided manual deep lamellar keratoplasty.
OBJECTIVE
To evaluate the efficacy of a new modified technique of deep lamellar keratoplasty (DLK).


METHODS
Nine eyes of eight patients with keratoconus of moderate degree were included. All patients underwent DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. The patients underwent a complete ophthalmologic examination 6 months after the suture removal, evaluating best-corrected visual acuity, corneal thickness, endothelial cell count, and topographic astigmatism.


RESULTS
One case (11.1%) was converted to penetrating keratoplasty because of microperforation. In the eight successful cases, 7 eyes (77.8%) achieved 20/30 or better visual acuity 6 months after suture removal. Mean postoperative pachymetry was 604.76 microm (SD 46.76). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2273/mm2 (SD 229).


CONCLUSIONS
This modified DLK technique is a safe and effective procedure and could facilitate, after a short learning curve, this kind of surgery with a low risk of conversion to penetrating keratoplasty.
Department of Ophthalmology and Neurosurgery, University of Siena, Policlinico Le Scotte, Italy. caporossi@unisi.it
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Caporossi
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Simi
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Licignano
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Traversi
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Balestrazzi
D000328:Adult; D000388:Air; D002452:Cell Count; D003315:Cornea / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012449:Safety; D014792:Visual Acuity