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Microkeratome-assisted two-stage technique of superficial anterior lamellar keratoplasty for Reis-Bücklers corneal dystrophy.
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The
aim
of
this
study
was
to
describe
a
microkeratome-assisted
2
-
stage
technique
of
superficial
anterior
lamellar
keratoplasty
(
SALK
)
to
manage
Reis-
Bucklers
corneal
dystrophy
(
RBCD
)
.
A
microkeratome
was
used
to
create
a
9
-
mm
,
140
-
μm-
thick
corneal
flap
in
the
first
stage
.
Four
weeks
later
,
in
the
second
stage
,
a
Hessberg-
Baron
suction
trephine
was
used
to
perform
a
7
.
0
-
mm
central
trephination
up
to
a
depth
of
150
μm
,
within
the
corneal
flap
.
Donor
lamellar
tissue
was
prepared
using
a
microkeratome
system
,
after
which
a
vacuum
punch
was
used
to
trephine
a
7
.
0
-
mm
lamellar
button
.
This
donor
button
was
used
to
replace
the
central
corneal
flap
in
the
recipient
cornea
without
using
any
sutures
.
A
bandage
contact
lens
was
applied
for
2
weeks
.
This
modified
technique
of
staged
sutureless
SALK
was
used
in
4
eyes
of
2
patients
with
RBCD
.
Postoperatively
,
all
eyes
experienced
an
improvement
in
both
uncorrected
and
best
spectacle-corrected
visual
acuities
.
The
average
best
spectacle-corrected
visual
acuity
was
20
/
30
at
the
last
follow-up
(
19
months
,
range
16
-
22
months
)
.
The
cornea
remained
clear
in
all
eyes
until
the
last
follow-up
without
any
evidence
of
recurrence
of
RBCD
.
T
he
staged
technique
of
microkeratome-assisted
SALK
allows
the
replacement
of
superficial
corneal
stroma
without
the
necessity
for
any
sutures
and
seems
to
be
a
safe
and
effective
method
for
the
treatment
of
RBCD
.
