title: Microkeratome-assisted two-stage technique of superficial anterior lamellar keratoplasty for Reis-Bücklers corneal dystrophy.
abstract: OBJECTIVE
  The aim of this study was to describe a microkeratome-assisted 2-stage technique of superficial anterior lamellar keratoplasty (SALK) to manage Reis-Bucklers corneal dystrophy (RBCD).
  
  
  METHODS
  A microkeratome was used to create a 9-mm, 140-μm-thick corneal flap in the first stage. Four weeks later, in the second stage, a Hessberg-Baron suction trephine was used to perform a 7.0-mm central trephination up to a depth of 150 μm, within the corneal flap. Donor lamellar tissue was prepared using a microkeratome system, after which a vacuum punch was used to trephine a 7.0-mm lamellar button. This donor button was used to replace the central corneal flap in the recipient cornea without using any sutures. A bandage contact lens was applied for 2 weeks.
  
  
  RESULTS
  This modified technique of staged sutureless SALK was used in 4 eyes of 2 patients with RBCD. Postoperatively, all eyes experienced an improvement in both uncorrected and best spectacle-corrected visual acuities. The average best spectacle-corrected visual acuity was 20/30 at the last follow-up (19 months, range 16-22 months). The cornea remained clear in all eyes until the last follow-up without any evidence of recurrence of RBCD.
  
  
  CONCLUSIONS
  The staged technique of microkeratome-assisted SALK allows the replacement of superficial corneal stroma without the necessity for any sutures and seems to be a safe and effective method for the treatment of RBCD.
authors.affiliation: *Department of Ophthalmology, Apollo Hospitals, Andhra Pradesh, Hyderabad, India; and †Faculty of Health Sciences, Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Fogla
authors.forename: Boris
authors.initials: B
authors.lastname: Knyazer
mesh_terms: D000328:Adult; D002648:Child; D003317:Corneal Dystrophies, Hereditary / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology