TechniquesSurgical Management of Healed Hydrops: A Novel Modification of Deep Anterior Lamellar KeratoplastyRamamurthi, S FRCS; Ramaesh, K FRCOphthAuthor Information From the *Eye Department, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Lanarkshire, United Kingdom. Received for publication February 1, 2009; revision received October 17, 2009; accepted October 27, 2009. Reprints: Dr. S. Ramamurthi, Tennent Institute of Ophthalmology, 1053, Great Western Rd, Glasgow G12 0YN, Lanarkshire, United Kingdom (e-mail: [email protected]). Cornea: February 2011 - Volume 30 - Issue 2 - p 180-183 doi: 10.1097/ICO.0b013e3181ca2b8c Buy Metrics Abstract Purpose: The purpose of this case series was to evaluate the effectiveness of modified deep anterior lamellar keratoplasty in eyes with scarring secondary to hydrops associated with keratoconus. Methods: Four patients underwent modified deep anterior lamellar keratoplasty. This was performed by controlled air injection and layer-by-layer dissection of the corneal stroma. The corneal stroma was dissected up to 95% thickness using a Beaver blade. The host Descemet membrane (DM) (4 mm in diameter) that was incorporated in the scar was excised. The DM and the endothelium from the donor button were removed, and the graft was applied to the recipient bed. Twenty percentage sulfur hexafluoride gas was injected to tamponade the host DM to the donor cornea. The graft was sutured with 10-0 monofilament nylon. An amniotic membrane dressing was applied. Results: The preoperative visual acuity was between counting fingers to 6/36. Six weeks postoperatively, the grafts were clear. At 1-year follow-up, the best-corrected visual acuity was 6/12 or better in all patients. Conclusion: Modification of deep anterior lamellar keratoplasty may be an effective alternative to penetrating keratoplasty in eyes with corneal scarring because of previous hydrops. Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.