Lamellar Corneal Transplantation

Abstract Penetrating keratoplasty (PK) has been the gold standard for the surgical treatment of most corneal pathologies; lamellar keratoplasty that only replaces the diseased corneal layers has recently evolved as an alternative, however. Innovations in surgical technique and instrumentation provid...

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Bibliographic Details
Published in:Survey of ophthalmology 2012-11, Vol.57 (6), p.510-529
Main Authors: Arenas, Eduardo, MD, Esquenazi, Salomon, MD, Anwar, Mohammad, MD, Terry, Mark, MD
Format: Article
Language:English
Subjects:
ALK
Biological and medical sciences
Corneal Diseases - surgery
corneal surgery
corneal transplants
DALK
Descemet Stripping Endothelial Keratoplasty - methods
DMEK
DSAEK
Epikeratophakia - methods
Humans
keratoplasty
Keratoplasty, Penetrating - methods
Medical sciences
Miscellaneous
Ophthalmology
PKP
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Description
Summary:Abstract Penetrating keratoplasty (PK) has been the gold standard for the surgical treatment of most corneal pathologies; lamellar keratoplasty that only replaces the diseased corneal layers has recently evolved as an alternative, however. Innovations in surgical technique and instrumentation provide visual outcomes comparable to PK. We review the indications and outcomes of various techniques of anterior lamellar surgery developed to treat stromal disorders. Similarly, we discuss posterior lamellar keratoplasty techniques such as Descemet stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty. Posterior lamellar keratoplasty provides faster visual rehabilitation than PK in cases of Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. In addition, for medically unresponsive infectious keratitis, therapeutic anterior lamellar keratoplasty yields similar graft survival to PK without an increased risk of disease recurrence.
ISSN:0039-6257
1879-3304
DOI:10.1016/j.survophthal.2012.01.009