[Deep lamellar keratoplasty in severe ocular surface disease].
OBJECTIVE
To demonstrate the efficacy and safety of deep lamellar keratoplasty(DLKP) in the treatment of corneal opacity in severe ocular surface disease.


METHODS
A total of 12 eyes of 11 patients were analyzed in this retrospective case series. The original diseases were Stevens Johnson syndrome (SJS : 3 eyes), ocular ciccatricial pemphigoid(OCP : 2 eyes), thermal burns (2 eyes), limbal deficiency due to unknown cause (2 eyes), and corneal scarring due to trachoma (3 eyes). Cases with total limbal deficiency (6 eyes) were also treated with secondary or simultaneous limbal transplantation. Cataract surgery was also performed in 4 eyes following DLKP.


RESULTS
DLKP was successfully done in all cases. One case with SJS experienced an immunological rejection against the limbal graft. Two eyes with SJS eventually developed ulcers that required therapeutic penefrating keratoplasty. Visual improvement was observed in 9 out of 12 eyes, of which 2 cases maintained a corrected visual acuity of 0.1 despite conjunctivalization of the ocular surface.


CONCLUSIONS
DLKP is an effective means to treat stromal opacity in patients with ocular surface disease.
Shimmura
Shigeto
S
Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan. shige@sc.itc.keio.ac.jp
Higa
Akiko
A
Omoto
Masahiro
M
Shimazaki
Jun
J
Tsubota
Kazuo
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000601:surgery*; D003318:Corneal Opacity / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies