Posterior Eccentric Rotational Lamellar Keratoplasty

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Abstract

Purpose:

To determine if a new, nontransplant approach to surgically treat Fuchs' corneal dystrophy and other corneal endothelial disorders can be achieved by posterior rotation of the cornea.

Methods:

Femtosecond laser was used to create an eccentric posterior lamella of approximately 200 μm. Through a clear corneal incision, this posterior lamella is rotated to bring peripheral endothelium to the visual axis and diseased endothelium to the periphery.

Results:

Six cadaver eyes were used to show that IntraLase-assisted posterior endothelial rotational lamellar keratoplasty can be successfully performed. Results from initial patient outcomes indicate surgical feasibility and early promise in visual rehabilitation.

Conclusions:

Posterior endothelial rotational lamellar keratoplasty offers a new approach to treat Fuchs' corneal dystrophy and early bullous keratopathy by rotating healthy peripheral endothelium to the center without transplant tissue or sutures.

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