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Sutureless, Posterior Lamellar Keratoplasty: A Case Report of a Modified Technique.

Melles, Gerrit R.J. M.D., Ph.D.; Lander, Frank; Nieuwendaal, Carla M.D.

Case Reports

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 × 85°. 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 × 80°. 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.

From the Netherlands Institute for Innovative Ocular Surgery (G.R.J.M.), Rotterdam, The Netherlands; the Dutch Ophthalmic Research Center (F.L.), Zuidland, The Netherlands; and the Academic Medical Center (C.N.), Amsterdam, The Netherlands.

Presented at the American Academay of Ophthalmology, Dallas, Texas, October 2000.

Address correspondence and reprint requests to Dr. G.R.J. Melles, The Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands. E-mail: melles@niioc.nl. Website: http://www.Niioc.NL

© 2002 Lippincott Williams & Wilkins, Inc.