A new surgical technique of microkeratome-assisted deep lamellar keratoplasty with a hinged flap

We describe a new surgical technique of microkeratome-assisted deep lamellar keratoplasty for treating patients with corneal stromal disease and normal endothelium. A microkeratome is used to create a hinged anterior stromal flap in the host cornea, and the diseased stroma is resected or ablated. A complementary donor stromal button, prepared using a microkeratome and an artificial anterior chamber, is transplanted prior to repositioning of the flap. The flap may be lifted at a later date, and an excimer laser used to correct residual refractive errors. Notwithstanding the preliminary and theoretical nature of this report, this technique may improve the outcomes of deep lamellar keratoplasty and may allow for decreased postoperative complications. Arch Ophthalmol. 2000;118:1112-1115