BACKGROUND: Previously, penetrating keratoplasty has been used to trea
t corneal cap complications related to keratomileusis. We sought to de
velop a technique to avoid the unnecessary use of penetrating procedur
es for lamellar problems, that would be technically easier than standa
rd lamellar keratoplasty-sutureless homoplastic lamellar keratoplasty.
METHODS: Five eyes with complications from automated lamellar keratop
lasty underwent sutureless homoplastic lamellar keratoplasty utilizing
an automated microkeratome and topical anesthesia. RESULTS: Three of
the five eyes had improved vision; two eyes with final visual acuities
of 20/20 and 20/30. The two remaining eyes had poor host stromal beds
and required penetrating keratoplasty. The mean follow-up time was 13
months (range 3 to 36 months). All lamellar grafts were clear and wel
l-seated at the last postoperative examination. CONCLUSION: Sutureless
homoplastic lamellar keratoplasty is, an alternative to penetrating k
eratoplasty in some eyes that have cap-related problems.