Lamellar keratoplasty with a new automatic rotary microkeratome: preliminary results

ABSTRACT

Techniques of lamellar dissection of the cornea have been proposed and publicized for more than a hundred years. Initial attempts at heterologous transplantations often proved discouraging, while subsequent use of homologous tissue greatly reduced immunological reaction and clouding of the transplant. With modern techniques of dissection, wound surfaces can be obtained that are smooth and not additionally optically active [plano]; this greatly improves visual results. Among the first 12 lamellar keratoplasties performed by us with our automatic microkeratome, 4 eyes with keratoconus had not quite reached their best corrected preoperative visual acuity at 4 months after surgery [mainly because of wrinkles in Descemet's membrane], while all other eyes [3 with status post-superficial chemical burn, 2 with recurrent pterygium affecting the center of the cornea, 2 after microbial ulcer and keratitis and 1 with epithelial dystrophy] surpassed their preoperative visual acuity, sometimes considerably. Patients' ages ranged from 13 to 65 years. Complications included interface problems in the eye of our oldest patient [recurrent pterygium], and disturbances in epithelial healing in two eyes - one with keratoconus, and one with epithelial dystrophy. Postoperative astigmatism reached a maximum of 3.0 diopters