Deep lamellar keratoplasty by deep parenchyma detachment from the corneal limbs.
OBJECTIVE
To improve the deep lamellar keratoplasty technique.


METHODS
For the easy and reliable perfomance of deep lamellar keratoplasty (DLKP), detachment of Descemet's membrane through the corneal limber flap was improved. To expose Descemet's membrane, the parenchyma was detached by hydrodelamination through a sclerocorneal flap made in the corneal limbs. The parenchyma was removed after the pseudochamber between it and Descemet's membrane was maintained with viscoelastic material. The corneal graft was placed with a running suture. 22 eyes were treated.


RESULTS
Complete exposure of Descemet's membrane was obtained in 20 of the 22 eyes (91%). The membrane was perforated in five of the 22 eyes (23%) during surgery, and two of the 22 eyes (9%) were converted to penetrating keratoplasty. These two eyes developed keratoconus after acute corneal hydrops.


CONCLUSIONS
Compared with the conventional procedure, this new method provides easy, reliable exposure of Descemet's membrane.
Senoo
T
T
Dokkyo University School of Medicine, Department of Ophthalmology, Tochigi, Japan. senoo@dokkyomed.ac.jp
Chiba
K
K
Terada
O
O
Mori
J
J
Kusama
M
M
Hasegawa
K
K
Obara
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity