title: Wet-Peeling Technique of Deep Anterior Lamellar Keratoplasty With Hypotonic Water and Blunt Dissection for Healed Hydrops.
abstract: OBJECTIVE
  To describe the surgical technique and outcomes of "wet-peeling" deep anterior lamellar keratoplasty (DALK) using sterile water and blunt dissection in cases with corneal scarring after healed corneal hydrops.
  
  
  METHODS
  Manual DALK using a "wet-peeling" technique was performed in 20 eyes of 20 consecutive patients with healed corneal hydrops between June 2011 and October 2013.
  
  
  RESULTS
  Intraoperative microperforations were encountered in 2 (10%) cases. None of the cases required conversion to penetrating keratoplasty. There was significant improvement in mean best-corrected visual acuity at the end of 24 months postoperatively (0.99 ± 0.30 logMAR vs. 0.20 ± 0.11 logMAR; P < 0.001). The postoperative mean residual stromal bed thickness was 48.9 ± 5.9 μm, and mean central corneal thickness was 557.2 ± 50.3 μm. The mean endothelial density was 2021 ± 236 cells/mm at the final follow-up.
  
  
  CONCLUSIONS
  Manual DALK using sterile water can be successfully performed in corneas with healed hydrops. Favorable visual outcomes may be attributed to thin residual bed thickness postoperatively.
authors.affiliation: *Eye Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China; and †Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Zelin
authors.initials: Z
authors.lastname: Zhao
authors.forename: Jinyang
authors.initials: J
authors.lastname: Li
authors.forename: Qinxiang
authors.initials: Q
authors.lastname: Zheng
authors.forename: Wei
authors.initials: W
authors.lastname: Lin
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D002452:Cell Count; D015715:Corneal Edema / Q000503:physiopathology / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D004210:Dissection; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007038:Hypotonic Solutions; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D014792:Visual Acuity / Q000502:physiology; D014867:Water; D055815:Young Adult
chemical_list: D007038:Hypotonic Solutions; D014867:Water