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T. Kulkamthorn, A. Torres, T. L. Purcell, D. J. Schanzlin; A New Surgical Technique for Anterior Lamellar Keratoplasty Using Intracorneal Ring Dissector. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2339.
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© ARVO (1962-2015); The Authors (2016-present)
To describe a new surgical technique for anterior lamellar keratoplasty
Eye bank eye was prepared as a recipient by making a 1.2 mm radial incision with diamond knife at the edge of the 8.0 mm optical zone at ninety percent depth of central corneal thickness. Then a modified Suarez spreader was used to begin a lamellar corneal dissection. The curved tunnel was made using clockwise and counterclockwise dissecting instruments (Addition Technology, Fremont, California) comparable to Intacs channel creation (reference this by author and date). The radial incision was enlarged to make a small pocket by using the Suarez spreader. This pocket was enlarged utilizing a Martinez Spatula in a sweeping motion from the inner edge of the channels in a complete circle (360 degrees). An 8.0 mm Hessburg-Barron Vacuum Corneal Trephine (Baron Precision Instruments, LLC, Grand Blanc, MI) was placed over the 8.0 mm optical zone and rotated until the same depth was obtained as that previously formed by the channel dissector. The cap tissue was then removed and both the corneal cap tissue and stromal bed were immediately photographed for corneal cap and stromal bed surface analysis.
We found a smooth inner corneal cap surface as well as a smooth stromal bed surface.
From this corneal model we conclude that this modified anterior lamellar keratoplasty technique is fairly easy to perform and results in a more regular smooth stromal surface. This technique may reduce opacities, haze, and irregular astigmatism. Furthermore, this procedure may avoid inadvertent microperforation, thus reducing the need for PKP.
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