Fluid lamellar keratoplasty in keratoconus

Ophthalmology. 2000 Jan;107(1):76-9; discussion 80. doi: 10.1016/s0161-6420(99)00002-0.


Objective: The authors evaluated the efficacy of the modified technique of fluid deep lamellar keratoplasty in keratoconus.

Design: Noncomparative case series.

Participants: Twenty-six eyes of 25 patients with moderate to advanced keratoconus were included. Fourteen males and 11 females with age range of 16 to 37 years.

Intervention: Deep lamellar keratoplasty aided by intrastromal injection of balanced salt solution to facilitate corneal dissection down to Descemet's membrane. Full-thickness graft devoid of endothelium and Descemet's membrane was then sutured in place.

Main outcome measures: Spectacle-corrected visual acuity, slit-lamp biomicroscopy, corneal topography, and ocular tension.

Results: Two cases (8.4%) were converted to penetrating keratoplasty because of intraoperative perforation. Of the 24 successful cases, 19 eyes (79%) achieved >20/50 at 3 months and 21 (87.5%) achieved >20/40 at 6 months. Twenty-three eyes (95.8%) were 20/30 or better 1 year after suture removal. Only one eye (4.2%) had interface irregular astigmatism corrected by contact lens to 20/40.

Conclusions: Fluid deep lamellar keratoplasty is a safe and effective procedure, especially in bilateral keratoconus, because it has no rejection complication. However, it is technically difficult with slow visual rehabilitation.

MeSH terms

  • Adolescent
  • Adult
  • Contact Lenses
  • Cornea / pathology
  • Cornea / physiopathology
  • Cornea / surgery*
  • Corneal Topography
  • Corneal Transplantation / methods*
  • Female
  • Humans
  • Intraocular Pressure
  • Isotonic Solutions
  • Keratoconus / pathology
  • Keratoconus / physiopathology
  • Keratoconus / surgery*
  • Keratoplasty, Penetrating
  • Male
  • Visual Acuity


  • Isotonic Solutions