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Sutureless, posterior lamellar keratoplasty: a case report of a modified technique
Gerrit R J Melles1, Frank Lander, Carla Nieuwendaal
1Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands. melles@niioc.nl
Purpose:
To describe a technique for sutureless, posterior lamellar keratoplasty.
Methods:
The procedure was performed for a case of pseudophakic bullous keratopathy. Through a 5.0-mm, self-sealing scleral tunnel incision, a stromal pocket was dissected across the cornea, just above Descemet's membrane. An 8.5-mm diameter posterior lamellar disc, consisting of posterior stroma, Descemet's membrane, and endothelium, was transplanted without suture fixation.
Results:
One week after surgery, the best spectacle corrected visual acuity (BSCVA) was 0.8 (20/25), with S -1.5 and C -1.0 x 85 degrees. After 1 year, the posterior transplant was clear and in position, and the BSCVA was 0.8 with S -1.5 and C -1.75 x 80 degrees. Pachymetry measured 0.60 mm. Endothelial cell counts averaged 1390 cells/mm2.
Conclusion:
Sutureless, posterior lamellar keratoplasty may be an effective new surgical approach for managing corneal endothelial disorders.