Deep lamellar keratoplasty

The deep lamellar keratoplasty (DLK) consists in transplanting the stroma and the epithelium of the graft while preserving the Descemet membrane and the endothelium of the recipient. It is used to treat corneal bums in which the Descemet membrane and the endothelium have been spared. The graft is sampled and preserved in the same conditions as the graft used for a TK. The operation begins with an 8 mm... 

Yao, Y.F., Zhang, B., Zhou, R, Jiang, J.K. Autologous limbal grafting combined with deep lamellar keratoplasty in unilateral eye with severe chemical or thermal bum at late stage. Ophthalmology 109, 2011-2017 (2002)... 

Fogla, R., Padmanabhan, R Deep anterior lamellar keratoplasty combined with autologous limbal stem cell transplantation in unilateral severe chemical injury. Cornea 24, 421-425 (2005)... 

Figure 26-8 Diagram of the deep lamellar endothelial keratoplasty procedure for patients with Fuchs corneal dystrophy and pseudophakic bullous keratopathy. (Diagram courtesy of Dr. Mark Terry of the Devers Eye Institute in Portland, Oregon.)...

Early surgical debridement or keratectomy of all but the most superficial ulcers will improve the therapeutic outcome significantly (Grahn et al 1993). Other surgical options may be considered depending upon the clinical progress of the lesion (Brooks 1999). In particular, posterior lamellar keratoplasty is likely to markedly improve the clinical outcome of deep mycotic abscesses (Andrew et al 2000). 

A new surgical technique for deep stromae anterior lamellar keratoplasty was recently described using viscoelastic agents to separate the anterior corneal lamellar (Meller et al., 1999). 

Melles GR, Lander F, Rietfield FJ, Remeijer L, Beekhuis WH, Binder PS. A new surgical technique for deep stromae, anterior lamellar keratoplasty. Br J Ophthalmol 1999 83 327-333 Menezo JL, Taboada JF, Ferrer E. Complications of intraocular lenses in children. Trans Ophthalmol Soc UK 1985 104 546-552... 

In similar grafts into pigs and rabbits by deep anterior lamellar keratoplasty, however, integration was seamless and there was no retrocomeal membrane formed [115]. 

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