title: Lamellar keratoplasty using gamma-irradiated corneal lenticules.
abstract: OBJECTIVE
  To report the clinical outcomes of lamellar keratoplasty using sterile, gamma-irradiated corneal tissues (VisionGraft) for partial-thickness corneal defects.
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  The medical records of 10 patients with partial-thickness corneal defects who were operated at The Wilmer Eye Institute between April 2009 and December 2009 were retrospectively reviewed. Indications for surgery included corneal melt with microperforation (n = 6), keratoprosthesis-associated corneal melt (n = 2), and noninflammatory limbal lesions (n = 2). The grafts were fashioned from full- or partial-thickness tissues using disposable trephines, based on the depth, shape, and size of the defect in the recipient bed, and were secured with multiple interrupted 10/0 nylon sutures. Rate of epithelialization and clarity of the grafts at the last visit were assessed retrospectively.
  
  
  RESULTS
  All but 1 graft became epithelialized between postoperative 1st and 13th days. Corneal inflammation progressed in the 1 patient with Boston type 1 keratoprosthesis-associated corneal melt, probably attributable to the progression of underlying Sjögren syndrome, despite initiation of systemic immunomodulatory treatment, and required replacement of the device. The donor tissues remained clear in all the other cases over a period of 7 to 15 months. No immune rejection, infection, significant opacification, or neovascularization of the donor tissues were noted during a follow-up period.
  
  
  CONCLUSIONS
  VisionGraft may be considered in lieu of fresh donor corneas for lamellar corneal patch grafts because of its availability, easy handling, and lack of immunogenicity.
authors.affiliation: Ocular Surface Disease and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9238, USA.
authors.forename: Canan Asli
authors.initials: CA
authors.lastname: Utine
authors.forename: Jonathan Heng
authors.initials: JH
authors.lastname: Tzu
authors.forename: Esen Karamursel
authors.initials: EK
authors.lastname: Akpek
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003315:Cornea; D057112:Corneal Perforation / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D003320:Corneal Ulcer / Q000601:surgery*; D005260:Female; D005720:Gamma Rays; D006801:Humans; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques