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Limbal Stem Cell–Sparing Lamellar Keratoplasty for the Management of Advanced Keratoglobus

Karimian, Farid MD; Baradaran-Rafii, Alireza MD; Faramarzi, Amir MD; Akbari, Mitra MD

doi: 10.1097/ICO.0b013e3182a9b1ac

Purpose: To describe the technique and outcomes of limbal stem cell–sparing lamellar keratoplasty (LSCS-LKP) for the management of advanced keratoglobus (KGB).

Methods: In a sequential interventional case series from March 2010 to December 2012, 8 eyes of 6 patients with advanced KGB underwent an LSCS-LKP. Three patients had isolated KGB, 2 were affected with the Ehlers–Danlos syndrome, and the other subject had osteogenesis imperfecta. Epithelial healing, anatomical results (corneal thickness and keratometry), and visual outcomes were evaluated after this intervention.

Results: Three of the 6 patients were male. Complete epithelial healing occurred in 7 eyes during 2 weeks. Refractory persistent epithelial defect and graft melting occurred in 1 eye. Corneal thickness increased and central keratometry decreased after the LSCS-LKP was performed in all the patients. The patients were followed up for at least 6 months. Visual acuity improved in all eyes except 1.

Conclusions: LSCS-LKP is an effective procedure for preserving ocular integrity and for improving visual acuity in patients with advanced KGB. Early surgical intervention can be considered before the occurrence of vision-threatening traumatic corneal rupture.

*Cornea and External Disease Service, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and

Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Reprints: Farid Karimian, Department of Ophthalmology, Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (e-mail:

The authors have no funding or conflicts of interest to disclose.

Received July 05, 2013

Accepted August 20, 2013

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