title: Limbal stem cell-sparing lamellar keratoplasty for the management of advanced keratoglobus.
abstract: OBJECTIVE
  To describe the technique and outcomes of limbal stem cell-sparing lamellar keratoplasty (LSCS-LKP) for the management of advanced keratoglobus (KGB).
  
  
  METHODS
  In a sequential interventional case series from March 2010 to December 2012, 8 eyes of 6 patients with advanced KGB underwent an LSCS-LKP. Three patients had isolated KGB, 2 were affected with the Ehlers-Danlos syndrome, and the other subject had osteogenesis imperfecta. Epithelial healing, anatomical results (corneal thickness and keratometry), and visual outcomes were evaluated after this intervention.
  
  
  RESULTS
  Three of the 6 patients were male. Complete epithelial healing occurred in 7 eyes during 2 weeks. Refractory persistent epithelial defect and graft melting occurred in 1 eye. Corneal thickness increased and central keratometry decreased after the LSCS-LKP was performed in all the patients. The patients were followed up for at least 6 months. Visual acuity improved in all eyes except 1.
  
  
  CONCLUSIONS
  LSCS-LKP is an effective procedure for preserving ocular integrity and for improving visual acuity in patients with advanced KGB. Early surgical intervention can be considered before the occurrence of vision-threatening traumatic corneal rupture.
authors.affiliation: *Cornea and External Disease Service, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and †Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Karimian
authors.forename: Alireza
authors.initials: A
authors.lastname: Baradaran-Rafii
authors.forename: Amir
authors.initials: A
authors.lastname: Faramarzi
authors.forename: Mitra
authors.initials: M
authors.lastname: Akbari
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology / Q000601:surgery*; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult