Preliminary clinical results of posterior lamellar keratoplasty through a sclerocorneal pocket incision

Ophthalmology. 2000 Oct;107(10):1850-6; discussion 1857. doi: 10.1016/s0161-6420(00)00253-0.


Purpose: To report the preliminary results of a surgical technique for transplantation of posterior corneal tissue through a sclerocorneal pocket incision for corneal endothelial disorders.

Design: Retrospective, noncomparative, interventional cases series.

Participants and intervention: In seven sighted human eyes, a deep stromal pocket was created across the cornea through a 9.0-mm superior scleral incision. A 7.0- or 7.5-mm diameter, posterior lamellar disc was excised and replaced by a 'same size' donor posterior disc, without suture fixation. The scleral incision was sutured.

Main outcome measures: Intra- and postoperative complications, best spectacle-corrected visual acuity, keratometry, topography, biomicroscopy, pachymetry, and endothelial cell density were evaluated.

Results: Six to 12 months after surgery, all transplants were clear and in position. Best spectacle-corrected visual acuity was limited by preexisting maculopathies in two eyes and varied from 20/80 to 20/20. Postoperative astigmatism averaged 1. 54 diopters (D; standard deviation [SD] +/- 0.81 D), pachymetry averaged 0.49 mm (SD +/- 0.09 mm), and postoperative endothelial cell density averaged 2520 cells/mm(2) (SD +/- 340 cells/mm(2)). In one eye, a microperforation occurred during stromal pocket dissection so that the procedure was converted into a penetrating keratoplasty.

Conclusions: Posterior lamellar keratoplasty through a sclerocorneal pocket incision is a feasible surgical approach to manage corneal endothelial disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cell Count
  • Cornea / pathology
  • Cornea / surgery*
  • Corneal Dystrophies, Hereditary / pathology
  • Corneal Dystrophies, Hereditary / surgery
  • Corneal Topography
  • Corneal Transplantation / methods*
  • Endothelium, Corneal / cytology
  • Female
  • Fuchs' Endothelial Dystrophy / pathology
  • Fuchs' Endothelial Dystrophy / surgery*
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Sclera / pathology
  • Sclera / surgery*
  • Surgical Flaps*
  • Suture Techniques
  • Visual Acuity