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Corneal Donor Tissue Preparation for Endothelial Keratoplasty
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Lamellar keratoplasty techniques.

Nadisha P Singh1, Dalia G Said2, Harminder Singh Dua1

  • 1Division of Clinical Neuroscience, University of Nottingham, UK.

Indian Journal of Ophthalmology
|August 22, 2018
PubMed
Summary
This summary is machine-generated.

Lamellar keratoplasty (LK) techniques like DALK and EK have advanced corneal transplantation, offering improved outcomes and reduced risks compared to traditional PK. These methods enhance graft survival and patient satisfaction.

Keywords:
Deep anterior Lamellar keratoplastyDescemet's membrane endothelial keratoplastyDescemet's stripping endothelial keratoplastyLamellar keratoplastypre-Descemet's endothelial keratoplasty

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Transplantation Biology

Background:

  • Penetrating keratoplasty (PK) historically faced challenges with endothelial rejection and induced astigmatism.
  • Lamellar keratoplasty (LK) techniques have evolved, offering safer and more effective alternatives.
  • Advancements in LK have led to improved understanding of corneal anatomy and surgical procedures.

Purpose of the Study:

  • To review the evolution of lamellar keratoplasty techniques.
  • To discuss the principles, outcomes, and limitations of various LK procedures.
  • To highlight the shift from PK to advanced LK methods.

Main Methods:

  • Review of surgical techniques including Deep Anterior LK (DALK), Descemet's Stripping EK (DSEK), Descemet's Membrane EK (DMEK), and Pre-Descemet's EK (PDEK).
  • Discussion of technological innovations like microkeratome and femtosecond laser.
  • Analysis of outcomes and limitations based on current clinical experience.

Main Results:

  • DALK has become the gold standard for anterior lamellar keratoplasty, eliminating endothelial rejection risk.
  • EK procedures have evolved from DSEK to DMEK and PDEK, offering reduced astigmatism and improved graft-host junctions.
  • Innovations have made LK techniques more predictable and accessible, leading to procedures like Bowman Membrane Transplant (BMT).

Conclusions:

  • Lamellar keratoplasty has significantly improved corneal graft surgery outcomes.
  • DALK and advanced EK techniques are largely replacing PK in specialist centers.
  • Ongoing innovation continues to refine LK procedures for better patient results and satisfaction.