Grafting of the posterior cornea. Description of a new technique with 12-month clinical results

Purpose: To describe the technique of grafting only the posterior cornea an d to report 12-month clinical results. Method: A two-layer technique with an anterior recipient flap created by a microkeratome and a posterior penetrating donor graft allows for a watertig ht wound closure and at the same time a peroperative correction of astigmat ism. Four eyes (3 patients) were followed for 12 months. Results: The surgical technique could be completed in all cases without com plications. The postoperative course was uneventful. The intrastromal absor bable sutures disappeared spontaneously and completely. Graft thickness sho wed the expected B-month minimum while recipient flag thickness remained co nstant. After 1 year endothelial cell densities were 1200-2300 cells/mm(2). Confocal microscopy showed activated keratocytes in the flap and quiescent keratocytes in the donor tissue by one year. The anterior chamber depth wa s normal in all cases. The optical quality of the cornea was studied by aut omatic keratometry and keratoscopy (TMS). The obtained optical properties w ere not optimal. Conclusions: The developed novel technique gives a better wound closure and a complication free postoperative course. It may allow for better control of postoperative astigmatism. In order to disseminate the use of the techni que, eyebanks should supply posterior corneas to the surgeon.