title: [Evaluation of performance, efficacy and safety of semi-automated lamellar keratoplasty].
abstract: OBJECTIVE
  To evaluate the feasibility, efficacy and safety of a manual microkeratome and an artificial anterior chamber for lamellar keratoplasty (ALTK system).
  
  
  METHODS
  Twenty-one eyes with superficial corneal opacities were submitted to semi-automated lamellar keratectomy. In recipient eyes keratectomy was performed as in refractive surgery. The donor flap was removed from the preserved corneal shell using the same microkeratome and an artificial anterior chamber. Lamella thickness was measured through ultrasound biomicroscopy (UBM) after surgery.
  
  
  RESULTS
  The surgeries were accomplished successfully in 19 eyes. 80% of the flaps obtained in donated corneas and 84.2% of the flaps in recipient eyes had an up to 0.5 mm variation variation of the desired diameter. A high similarity in flap thickness between the donor flap and the recipient cornea was obtained. Postoperative visual acuity of 20/40 or better was observed in 52.6% of the eyes. Complications such as undesired diameter of the flap, a case of perforation in the recipient eye and a case of cornea ectasia were observed.
  
  
  CONCLUSIONS
  The semi-automated lamellar keratoplasty ALTK system showed to be feasible due to the predictability and reproducibility regarding lamella thickness and diameter, efficient in the improvement of postoperative visual acuity and safe due to the low level surgical complication.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil. nubiamaia@uol.com.br
authors.forename: Núbia Cristina de Freitas
authors.initials: NC
authors.lastname: Maia
authors.forename: Wallace
authors.initials: W
authors.lastname: Chamon
authors.forename: Bruno
authors.initials: B
authors.lastname: Castelo Branco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000209:etiology; D003318:Corneal Opacity / Q000601:surgery*; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects / Q000295:instrumentation / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015203:Reproducibility of Results; D014019:Tissue Donors; D014792:Visual Acuity / Q000502:physiology