Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy.

ABSTRACT

PURPOSE: To describe a new surgical technique for posterior corneal transplantation. METHODS: An elderly patient had painful, pseudophakic bullous keratopathy with low visual potential. Through a 9.0-mm scleral tunnel incision, a midstromal pocket was dissected across the cornea, and a posterior lamellar disk 7.0-mm in diameter, which consisted of posterior stroma, Descemet membrane, and endothelium, was excised. A similarly shaped donor posterior disk was implanted in the recipient opening without suture fixation, and the scleral incision was sutured. RESULTS: Throughout the postoperative period, the posterior corneal transplant remained clear and in position. Three months after surgery, the "suture-in" astigmatic error was 3.5 diopters. Pachymetry measured 0.44 mm. CONCLUSION: Posterior lamellar keratoplasty may be a new surgical approach with which to manage corneal endothelial disorders.