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      Femtosecond laser-assisted in situ keratomileusis for the correction of residual ametropia after deep anterior lamellar keratoplasty: a pilot investigation

      Author(s): , , , , , ,
      Publication date Created:
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      Journal: Eye
      Publisher: Springer Nature

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          Abstract

          Femtosecond laser-assisted in situ keratomileusis for the correction of residual ametropia after deep anterior lamellar keratoplasty: a pilot investigation

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          Most cited references17

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          Descemetic DALK and predescemetic DALK: outcomes in 236 cases of keratoconus.

          Vincenzo Sarnicola, D Gentile, S Hannush … (2009)
          To report the outcomes of our experience with deep anterior lamellar keratoplasty (DALK) in patients with keratoconus. A retrospective evaluation of 236 eyes of 198 patients that have undergone DALK between 2000 and 2006 using the Tsubota, Sugita, Melles, or Anwar technique. We analyzed the frequency of true Descemet membrane exposure, which we termed dDALK, and the number of eyes in which a predescemetic plane was achieved, which we termed pdDALK. Pre- and postoperative visual acuity, endothelial cell count, and central corneal thickness were evaluated on 120 eyes followed in our department. A total of 139 of 236 (59%) eyes were classified as dDALK, with the Anwar technique showing the highest incidence of exposure of Descemet's membrane (127 of 164, 77%). Descemet ruptures occurred in 25 of 236 cases (10.5%). Three ruptures were converted to penetrating keratoplasty (PK). There was no difference in visual acuity between the pdDALK and dDALK groups at an average follow-up of 30.4 months, although the eyes in the dDALK group seemed to have faster visual recovery. Best spectacle corrected visual acuity postoperatively was at least 20/30 in 80-85% of eyes at the patient's last visit. Endothelial cell loss was 11-13%, with most of the loss occurring in the first 6 months. Performing DALK, we had the greatest likelihood of reaching Descemet's membrane with the Anwar Big Bubble technique. The visual outcomes are comparable to standard PK, avoiding the risk of endothelial rejection. Endothelial cell loss was low and the cell count was stable after 6 months.
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            Deep anterior lamellar keratoplasty.

            Shigeto Shimmura, Shigeto Shimmura, Kazuo Tsubota (2006)
            Recent advances in surgical technique have promoted a paradigm shift in the surgical treatment of corneal disease. Penetrating keratoplasty is now being replaced by various types of lamellar techniques that aim to replace damaged tissue only, while maintaining healthy tissue intact. This review focuses on recent advances in deep anterior lamellar keratoplasty. The concept of creating a deep lamellar bed for lamellar keratoplasty is not new, but exposing Descemet's membrane was a tedious, time consuming procedure. New techniques that use air and ophthalmic viscosurgical devices to directly expose Descemet's membrane have dramatically reduced surgery time, while improving the safety of performing surgery. The indications for deep anterior lamellar keratoplasty have expanded from keratoconus and hereditary dystrophies, to include severe ocular surface disease and cases following infection and corneal perforation. Deep anterior lamellar keratoplasty can be considered as the first choice of surgery for a wide range of corneal disease, with bullous keratopathy as the only absolute contraindication.
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              A new surgical technique for deep stromal, anterior lamellar keratoplasty

              G Melles, F Lander, F J R Rietveld … (1999)
              Article 0 comments Cited 22 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Eye
                Abbreviated Title: Eye
                Publisher: Springer Nature
                ISSN (Print): 0950-222X
                ISSN (Electronic): 1476-5454
                Publication date Created: April 07 2017
                Publication date (Print): April 07 2017
                Volume:
                Issue:
                Article
                DOI: 10.1038/eye.2017.44
                PMC ID: 5558217
                PubMed ID: 28387767
                SO-VID: a8f55b12-c80a-4940-9716-713f93e3622c
                Copyright © © 2017
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