Grj. Melles et al., Preliminary clinical results of posterior lamellar keratoplasty through a sclerocorneal pocket incision, OPHTHALMOL, 107(10), 2000, pp. 1850-1856
Purpose: To report the preliminary results of a surgical technique for tran
splantation of posterior corneal tissue through a sclerocorneal pocket inci
sion 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 inci
sion. A 7.0- or 7.5-mm diameter, posterior lamellar disc was excised and re
placed by a 'same size' donor posterior disc, without suture fixation. The
scleral incision was sutured.
Main Outcome Measures: Intra- and postoperative complications, best spectac
le-corrected visual acuity, keratometry, topography, biomicroscopy, pachyme
try, 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 as
tigmatism averaged 1.54 diopters (D; standard deviation [SD] +/- 0.81 D) pa
chymetry averaged 0.49 mm (SD +/- 0.09 mm), and postoperative endothelial c
ell density averaged 2520 cells/mm(2) (SD +/- 340 cells/mm(2)). In one eye,
a microperforation occurred during stromal pocket dissection so that the p
rocedure was converted into a penetrating keratoplasty.
Conclusions: Posterior lamellar keratoplasty through a sclerocorneal pocket
incision is a feasible surgical approach to manage corneal endothelial dis
orders. Ophthalmology 2000;107:1850-1857 (C) 2000 by the American Academy o
f Ophthalmology.