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Katarzyna Iwona Palka; First results of novel Mikrokeratome and Excimer Laser-Assisted Endothelial Keratoplasty (MELEK). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1592.
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© ARVO (1962-2015); The Authors (2016-present)
To report first clinical results (6 months) of novel excimer laser based posterior lamellar keratoplasty in eyes with endothelial pathologies.
The new technique is a modified version of ultrathin DSAEK. Before corneal trepanation and implantation the graft is prepared by a single cut of a microkeratome (Moria, 300 µm cutter) followed by an OCT controlled (Online Pachymetry, Heidelberg Engineering) stromal excimer-laser (Esiris, Schwind) thinning (100 µm) and smoothing within the 8 mm optical zone. Visual acuity, endothelial cell density, cornea and graft thickness were evaluated 1,3 and 6 months after surgery.
29 eyes of 27 patients were included. The mean BCVA was preoperatively 0,28 ±0,13 (decimal), 0,37±0,12 after 1 month, 0,5±0,19 after 3 months and 0,7±0,17 after 6 months respectively. The mean central corneal thickness (CCT) decreased from 696±109 µm preoperatively to 710±92 µm after 1 month postoperatively, to 647±81 µm after 3 months and to 94±14 µm after 6 months. In 17% of the cases a single rebubbling procedure was necessary. The median endothelial cell loss after 6 months was 53%.
Mikrokeratome and Excimer Laser-Assisted Endothelial Keratoplasty (MELEK) represents a further development in posterior lamellar keratoplasty surgery showing excellent first clinical results. In future it may have the potential to improve the visual outcome in patients with endothelial pathologies.
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