Abstract

CAPOTE CABRERA, Armando et al. New variant of deep anterior lamellar keratoplasty through sclerolimbal approach with the viscodisection technique. Rev Cubana Oftalmol [online]. 2013, vol.26, n.3, pp. 427-438. ISSN 0864-2176.

Objectives: To describe the characteristics of the new variant of deep anterior lamellar keratoplasty through approach from the sclerolimbal area and using the viscodisection technique, and to analyze the results achieved in this experimental surgery. Methods: The procedure was performed in 10 human eyeballs not useful for transplantation purposes at "Ramon Pando Ferrer" Cuban Institute of Ophthalmology. Through a radial incision at the sclera adjacent to the limbus, one dissected until the darker corneal tissue was visualized, thus indicating the pre-Descemet plane. By means of the created space, one moved forward and injected visco-elastic substance to detach in a controlled way the Descemet membrane and the endothelium. Results: It was possible to complete the procedure in all the eyes until the dissection of Descement membrane was achieved. Eight of the eyes (80%) did not show any intraopeative complication, one (10%) suffered peripheral perforation of Descement membrane, but the procedure was completed satisfactorily by making another similar incision. The other eye (10%) underwent rupture of the Descemet membrane when the visco-elastic substance was injected to extend the detachment. In all the cases, it managed to dissect and isolate the transparent Descemet membrane with smooth and homogeneous surface. The surgical time was 18.4 minutes. Conclusions: The suggested technique proved to be safe and rapid in the enucleated eyeballs. The dissection was practiced in a safer peripheral area. This procedure can also be useful for dissection of Descemet membrane aimed at endothelial keratoplasty of the mentioned membrane.

Keywords : deep anterior lamellar keratoplasty; sclerolimbal approach; viscodisecction.

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