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[Lamellar keratoplasty. Back to the future?!]
G Geerling1, G I W Duncker, J Krumeich
1Klinik für Augenheilkunde, Bayerische Julius-Maximilian-Universität Würzburg. g.geerling@augenklinik.uni-wuerzburg.de
Summary
Anterior lamellar keratoplasty (LKP) offers a less invasive alternative to penetrating keratoplasty (PKP), reducing immune rejection risks. Innovative techniques now enable precise dissection for improved outcomes in various corneal graft indications.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Corneal Transplantation
Context:
- Penetrating keratoplasty (PKP) has been the standard for corneal grafts, despite risks.
- PKP involves replacing all corneal layers, potentially unnecessary for certain pathologies.
- Anterior lamellar keratoplasty (LKP) techniques were described early but gained traction later.
Purpose:
- To review and compare anterior lamellar keratoplasty (LKP) and penetrating keratoplasty (PKP).
- To discuss innovative lamellar dissection techniques for recipient and donor corneas.
- To evaluate LKP and related techniques for both optical and tectonic corneal graft indications.
Summary:
- Recent advancements allow precise lamellar dissection, enabling selective replacement or preservation of corneal layers.
- This precision minimizes the risk of immune reactions, a key advantage of anterior LKP.
- The discussion covers surgical techniques, outcomes, and challenges of various LKP types for optical and tectonic purposes.
Impact:
- Advances in LKP offer a safer alternative to PKP, particularly for reducing graft immune rejection.
- New techniques allow for tailored corneal transplantation, preserving healthy host tissue.
- Improved surgical precision in LKP enhances visual acuity and reduces complications for patients needing corneal grafts.