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Ophthalmology. 2000 Oct;107(10):1850-6; discussion 1857.

Preliminary clinical results of posterior lamellar keratoplasty through a sclerocorneal pocket incision.

Author information

1
The Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands. melles@melles.demon.nl

Abstract

PURPOSE:

To report the preliminary results of a surgical technique for transplantation of posterior corneal tissue through a sclerocorneal pocket incision for corneal endothelial disorders.

DESIGN:

Retrospective, noncomparative, interventional cases series.

PARTICIPANTS AND INTERVENTION:

In seven sighted human eyes, a deep stromal pocket was created across the cornea through a 9.0-mm superior scleral incision. A 7.0- or 7.5-mm diameter, posterior lamellar disc was excised and replaced by a 'same size' donor posterior disc, without suture fixation. The scleral incision was sutured.

MAIN OUTCOME MEASURES:

Intra- and postoperative complications, best spectacle-corrected visual acuity, keratometry, topography, biomicroscopy, pachymetry, and endothelial cell density were evaluated.

RESULTS:

Six to 12 months after surgery, all transplants were clear and in position. Best spectacle-corrected visual acuity was limited by preexisting maculopathies in two eyes and varied from 20/80 to 20/20. Postoperative astigmatism averaged 1. 54 diopters (D; standard deviation [SD] +/- 0.81 D), pachymetry averaged 0.49 mm (SD +/- 0.09 mm), and postoperative endothelial cell density averaged 2520 cells/mm(2) (SD +/- 340 cells/mm(2)). In one eye, a microperforation occurred during stromal pocket dissection so that the procedure was converted into a penetrating keratoplasty.

CONCLUSIONS:

Posterior lamellar keratoplasty through a sclerocorneal pocket incision is a feasible surgical approach to manage corneal endothelial disorders.

PMID:
11013184
DOI:
10.1016/s0161-6420(00)00253-0
[Indexed for MEDLINE]

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