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Central lamellar keratoplasty for optical indications
H K Soong1, D G Katz, A A Farjo
1W.K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor 48105, USA. hksoong@umich.edu
Cornea
|May 21, 1999
Summary
Lamellar keratoplasty (LKP) offers a safer alternative for optical indications, but vision can be limited by graft-host interface issues and astigmatism. Improving surgical technique and donor tissue standards may enhance LKP outcomes.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Transplantation
Background:
- Lamellar keratoplasty (LKP) is a surgical procedure used for various corneal conditions.
- It is considered a safer alternative to penetrating keratoplasty for optical indications.
- Understanding the long-term outcomes and challenges of LKP is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the 19-year outcomes of lamellar keratoplasty (LKP) for optical indications.
- To identify the advantages and limitations of LKP.
- To assess factors influencing visual acuity and graft success.
Main Methods:
- Retrospective review of 52 central LKPs in 37 patients.
- Assessment of Snellen visual acuity, preoperative indications, and postoperative corneal status.
- Analysis of graft-host interface and recipient cornea.
Main Results:
- Corneal dystrophies, aniridic keratopathy, scars, and keratoconus were primary indications.
- 38% of eyes achieved 20/50 or better visual acuity post-surgery.
- Graft-host interface opacification/vascularization and high astigmatism were main causes of poor vision; 21% had persistent epithelial defects.
Conclusions:
- LKP is safer than penetrating keratoplasty but faces challenges with graft-host interface issues, astigmatism, and surgical technique.
- Improving LKP outcomes may involve maximizing recipient stroma removal or using microkeratomes.
- Enhanced eyebank standards for donor tissue are recommended to improve LKP results.