title: Manual deep lamellar keratoplasty: alternative methods and air-guided technique.
abstract: OBJECTIVE
  To describe the techniques proposed for performing deep lamellar keratoplasty (DLK) and to evaluate the efficacy of a new, modified technique.
  
  
  METHODS
  Fourteen eyes in 11 patients with keratoconus of moderate degree were included. All patients underwent a DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. All patients had 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 (7.1%) was converted to penetrating keratoplasty because of microperforation. In the 13 successful cases, 10 eyes (71.4%) achieved 20/30 or better 6 months after suture removal. Mean postoperative pachymetry was 628.39 micro (SD 57.34). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2261 (SD 287/mm(2)).
  
  
  CONCLUSIONS
  Comparing this modified DLK technique with other methods proposed by several authors, air-guided DLK seems to be safe and effective and, after a short learning curve, can be performed with a low risk of conversion to penetrating keratoplasty.
authors.affiliation: Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Caporossi
authors.forename: A
authors.initials: A
authors.lastname: Balestrazzi
authors.forename: C
authors.initials: C
authors.lastname: Simi
authors.forename: T
authors.initials: T
authors.lastname: Caporossi
authors.forename: C
authors.initials: C
authors.lastname: Traversi
mesh_terms: D000328:Adult; D002138:Calibration; D016039:Corneal Transplantation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D008297:Male; D016896:Treatment Outcome