Purpose

Posterior lamellar keratoplasty (PLK) in patients with pseudophakic corneal oedema

Material and methods

The PLK have been performed in our department since November 2004. The studied group consisted of 8 patients (7 female and 1male), 65 to 82 years of age (mean age: 71.5 years). Visual acuity before the surgery ranged from 0.01 to fingers counting. All the patients suffered from pseudophakic corneal oedema. Endothelial keratoplasty was performed using Melles technique: a deep stromal pocket was created across the cornea through a 5-mm scleral access incision. Endothelium was prepared from whole eyeballs collected according to the EEBA guidelines. Donor disc containing healthy endothelium was folded during the implantation procedure. Average donor endothelial cell density was 2800 cells/mm2 . All surgeries were performed by one surgeon (EW).

Results

In two eyes conversion to PKP was necessary. Best corrected visual acuity (BCVA) ranged from 0.4 to 1.0 (mean 0.6 ± 0.12). Postoperative astigmatism ranged from 0.75 to 2.5 D (mean 1.8 D ± 0.34). Postoperative endothelial cell density ranged from 1700 do 2300 cells/mm2 (mean 2200 cells/mm2 ±150). Mean Postoperative endothelial cell loss came to 29%

Conclusions

Posterior lamellar keratoplasty is a feasible surgery to manage corneal endothelial disorders. Automation of procedures by the use of laser preparation of donor tissue and adaptation automatic microkeratomes will increase the afterrepeating of procedures.