GE)E LAMELLAR HORSE-SHOE SCLEROKERATOPLASTY AND THERMOPLASTY FOR KERATOCONUS WITH PERIPHERAL ECTASIA OF THE CORNEA

Purpose Peripheral ectasia of the cornea is a rare, but rather complic ated form of keratoconus, which in its severest form cannot be correct ed by glasses or contact lenses. Penetrating corneal grafts must be po sitioned directly at the limbus. Such transplants mostly fail because of a high risk of immune reactions which can only be circumvented by s ystemic Ciclosporin A. To avoid the potential risks of such a systemic immunomodulation we performed instead of a penetrating keratoplasty a special lamellar procedure which restored the normal configuration of the cornea. Patient The 35-year-old man presented with best corrected visual acuity of 0.1 in both eyes. Contact lenses were not tolerated any longer. Result After lamellar dissection, thermoplasty and lamella r horse-shoe sclerokeratoplasty the patient now wears well-fitting con tact lenses and has a visual acuity of 0.8 with his right and 0.5 with his left eye after a follow-up period of 25 and 14 months respectivel y. There were no postoperative complications. Conclusion Lamellar hors e-shoe sclerokeratoplasty preceeded by lamellar corneal dissection and thermoplasty is a technically difficult, but efficient surgical measu re to restore the normal corneal curvature in patients with advanced p eripheral ectasia of the cornea.