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Microkeratome-assisted posterior keratoplasty
D T Azar1, S Jain, R Sambursky
1Corneal and Refractive Surgery Services, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA. dazar@meei.harvard.edu
Journal of Cataract and Refractive Surgery
|March 20, 2001
Summary
Microkeratome-assisted posterior keratoplasty offers a novel approach for corneal decompensation. This technique involves creating a stromal flap for diseased tissue removal and donor graft insertion, potentially improving outcomes.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Tissue Transplantation
Background:
- Corneal decompensation due to endothelial dysfunction requires advanced treatment options.
- Current posterior keratoplasty techniques may have limitations in tissue integration and refractive correction.
Observation:
- A microkeratome is used to create a hinged anterior stromal flap in the host cornea.
- The diseased posterior stroma and endothelium are resected through this flap.
- A donor stromal button is prepared using a microkeratome and an artificial anterior chamber.
Findings:
- The donor button is transplanted and secured with sutures, with the flap repositioned.
- The anterior stromal flap allows for suture removal or refractive error correction with an excimer laser.
- This method facilitates the use of infant corneal donor tissue.
Implications:
- Microkeratome-assisted posterior keratoplasty presents a promising surgical technique for endothelial dysfunction.
- The technique may enhance outcomes in posterior keratoplasty by enabling flap manipulation for follow-up procedures.
- Potential for improved utilization of donor corneal tissue, including infant tissue, is highlighted.