New perspectives on lamellar keratoplasty

Area of Science:

• Ophthalmology and Vision Science
• Surgical Innovation in Corneal Transplantation

Background:

• Corneal transplantation traditionally involves replacing the entire cornea (penetrating keratoplasty).
• Lamellar keratoplasty selectively replaces diseased corneal layers, preserving healthy host tissue.
• This approach offers potential benefits like reduced graft rejection and improved visual recovery.

Purpose of the Study:

• To review the advancements and applications of lamellar keratoplasty techniques.
• To highlight the advantages of selective keratoplasty over penetrating keratoplasty.
• To discuss the impact of modern surgical techniques on corneal transplantation outcomes.

Main Methods:

• Categorization of lamellar keratoplasty into anterior (superficial and deep anterior lamellar keratoplasty - SALK, DALK) and posterior (endothelial keratoplasty - DSAEK, DMEK) approaches.
• Review of surgical techniques and instrumentation advancements over the past decade.
• Analysis of patient outcomes and benefits associated with these partial corneal transplantation methods.

Main Results:

• Lamellar keratoplasty techniques are becoming preferred for specific corneal dysfunctions affecting the stroma or endothelium.
• Advancements in surgical techniques and instruments have significantly improved corneal transplantation.
• These methods facilitate surgery, offer superior patient outcomes, and restore vision in corneal blindness.

Conclusions:

• Lamellar keratoplasty represents a significant advancement in treating corneal diseases, offering improved patient outcomes and visual rehabilitation.
• The continued development of surgical techniques enhances the efficacy and safety of partial corneal transplantation.
• Further long-term studies are necessary to fully evaluate the potential of these promising techniques.