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Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy1,

https://doi.org/10.1016/S0002-9394(98)00324-9Get rights and content

Abstract

PURPOSE:

To describe a new surgical technique for posterior corneal transplantation.

METHODS:

An elderly patient had painful, pseudophakic bullous keratopathy with low visual potential. Through a 9.0-mm scleral tunnel incision, a midstromal pocket was dissected across the cornea, and a posterior lamellar disk 7.0-mm in diameter, which consisted of posterior stroma, Descemet membrane, and endothelium, was excised. A similarly shaped donor posterior disk was implanted in the recipient opening without suture fixation, and the scleral incision was sutured.

RESULTS:

Throughout the postoperative period, the posterior corneal transplant remained clear and in position. Three months after surgery, the “suture-in” astigmatic error was 3.5 diopters. Pachymetry measured 0.44 mm.

CONCLUSION:

Posterior lamellar keratoplasty may be a new surgical approach with which to manage corneal endothelial disorders.

References (5)

  • G.R.J Melles et al.

    A surgical technique for posterior lamellar keratoplasty

    Cornea

    (1998)
  • G.R.J Melles et al.

    A technique to visualize corneal incision and lamellar dissection depth during surgery

    Cornea

    (1999)
There are more references available in the full text version of this article.

Cited by (192)

  • Advances in Endothelial Keratoplasty Surgery

    2021, Advances in Ophthalmology and Optometry
    Citation Excerpt :

    Given that most corneal transplants were for endothelial dysfunction, this novel surgical technique had the potential to transform treatment methods for patients with vision limiting endothelial pathology requiring corneal transplants. Posterior lamellar keratoplasty, as pioneered by Melles and colleagues [7], was the inaugural technique for the newly created field of endothelial keratoplasty. Endothelial keratoplasty, when clinically indicated, as compared with penetrating keratoplasty, has the advantages of a shorter recovery time, better visual outcomes, a lower risk of wound dehiscence, and less foreign antigen exposure.

  • Corneal endothelial dysfunction: Evolving understanding and treatment options

    2021, Progress in Retinal and Eye Research
    Citation Excerpt :

    However, when tightened, the sutures would actually pull the donor away from the central concave cornea. In contrast, Melles used an air bubble to hold the donor tissue in place, so that surface tension pushed the graft against the recipient cornea (Melles et al., 1999). The initial clinical EK technique used a 9-mm incision and included replacement of some posterior stroma as well as dysfunctional endothelium and Descemet membrane (Melles et al., 1998).

  • iPSC-Derived Corneal Endothelial Cells

    2023, Handbook of Experimental Pharmacology
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This study was supported by the Van Loenen Martinet Corneal Fellowship from the Rotterdamse Vereniging van Blindenbelangen, Rotterdam, The Netherlands (G.R.J.M., W.H.B.).

1

Accepted for publication Aug 28, 1998.

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