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Anterior Lamellar Surgery

  • Naoyuki MaedaEmail author
Chapter

Abstract

Anterior lamellar keratoplasty (ALK) is classified into two categories: superficial anterior lamellar keratoplasty (SALK) and deep anterior lamellar keratoplasty (DALK).

Superficial anterior lamellar keratoplasty consists of an automated lamellar therapeutic keratoplasty (ALTK) as an optical procedure for the superficial stromal disorders and lamellar grafting as a therapeutic procedure for corneal perforation, corneal thinning, or ocular surface diseases.

Recently, DALK has been actively performed for the stromal pathologies of the cornea with healthy corneal endothelium as a selective lamellar keratoplasty for optical purposes. DALK is also performed as a therapeutic procedure for serious corneal infection that does not respond to pharmacological therapy.

The advantages of DALK over penetrating keratoplasty are the elimination of endothelial rejection and better ocular integrity. As a trade-off, a steep learning curve, intraoperative complications such as corneal perforation and postoperative complications including double chamber, persistent stromal folds, and insufficient visual recovery due to residual stromal opacity may be found. To solve these problems in DALK, novel procedures and new instruments are being developed.

Keywords

Deep anterior lamellar keratoplasty Automated lamellar therapeutic keratoplasty Rejection reaction Selective lamellar keratoplasty Descemet’s membrane Femtosecond laser Big bubble technique 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of OphthalmologyOsaka University Graduate School of MedicineSuitaJapan

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