To describe a surgical technique to achieve the desired plane during deep anterior lamellar keratoplasty (DALK) in eyes with Descemet membrane (DM) tears due to previous hydrops.
This was a prospective, consecutive, interventional case series of DALK in 12 keratoconic eyes with healed hydrops. Dissection of the peripheral cornea was performed by air injection and using the microbubble incision technique as a guide to the clear predescemetic stroma. The central posterior scar was then removed by peeling to bare DM.
DALK was successfully completed in all eyes, with DM tears ranging from a microperforation to approximately 4 mm. At 12 months, the mean logMAR best-corrected visual acuity was 0.38 ± 0.07, the mean keratometric astigmatism was 5.2 ± 1.9 diopters, and the mean endothelial cell density was 2364 ± 316.9 cells/mm2.
Peripheral pneumatic dissection and central scar peeling technique is a useful technique to complete DALK in eyes with scars due to previous hydrops.
*Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt;
†Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom;
‡Brighton and Sussex Medical School, Brighton, United Kingdom; and
§Tongdean Eye Clinic, Hove, United Kingdom.
Correspondence: Mohamed Bahgat Goweida, FRCOphth, FRCS(Glasg), PhD, Department of Ophthalmology, Faculty of Medicine, Alexandria University, El-Khartoum Square, Azarita Medical Campus, Alexandria, Egypt (e-mail: firstname.lastname@example.org).
The authors have no funding or conflicts of interest to disclose.
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Received May 28, 2018
Received in revised form November 28, 2018
Accepted November 29, 2018