Air-Guided Manual Deep Lamellar Keratoplasty

Abstract

Purpose

To evaluate the efficacy of a new modified technique of deep lamellar keratoplasty (DLK).

METHODS

Nine eyes of eight patients with keratoconus of moderate degree were included. All patients underwent DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. The patients underwent a complete ophthalmologic examinations months after the suture removal, evaluating best-corrected visual acuity, corneal thickness, endothelial cell count, and topographic astigmatism.

Results

One case (11.1%) was converted to penetrating keratoplasty because of micro-perforation. In the eight successful cases, 7 eyes (77.8%) achieved 20/30 or better visual acuity 6 months after suture removal. Mean postoperative pachymetry was 604.76μm (SD 46.76). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2273/mm² (SD 229).

CONCLUSIONS

This modified DLK technique is a safe and effective procedure and could facilitate, after a short learning curve, this kind of surgery with a low risk of conversion to penetrating keratoplasty.