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01.10.2016 | originalarbeit | Ausgabe 4-5/2016 Open Access

Spektrum der Augenheilkunde 4-5/2016

Intraoperative management of macroperforations of Descemet’s membrane in deep anterior lamellar keratoplasty

Zeitschrift:
Spektrum der Augenheilkunde > Ausgabe 4-5/2016
Autoren:
MD Bernhard Steger, MD Vito Romano, MD Christoph Palme, MD, FRCS, FRCOphth Stephen B. Kaye
Wichtige Hinweise
B. Steger and V. Romano contributed equally to the preparation of this manuscript.

Summary

Background

To describe a surgical approach for the completion of pre-descemetic deep anterior lamellar keratoplasty (pdDALK) in the presence of a macroperforation of Descemet’s membrane (DM).

Methods

Using case notes, we recorded the details of the intra- and perioperative course of patients who underwent successful pdDALK in the presence of macroperforation. A literature search of pdDALK techniques available to the corneal surgeon in a similar scenario was undertaken.

Results

In two very different scenarios with intra- or preoperative perforation of DM, a centripetal layered lamellar dissection was performed and allowed completion of pdDALK with a residual recipient central stromal thickness of 36 and 115 µm and good visual outcome.

Conclusion

Despite very different scenarios, a centripetal layered lamellar dissection offers an approach for the completion of pdDALK in the presence of a macroperforation.
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