Al-Kharashi Soliman A, Al-Obailan Majed M, Almohaimeed Mansour, Al-Torbak Abdullah A
Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Saudi J Ophthalmol. 2009 Oct;23(3-4):203-9. doi: 10.1016/j.sjopt.2009.10.004. Epub 2009 Oct 24.
Keratoconus is a disease causing increased steepening of the cornea resulted in irregular astigmatism. Treatment options are Glasses, Hard contact lenses, Cross linking, Intracorneal Segments insertion, Refractive surgery (Gilda et al., 2008), or Keratoplasty. Lamellar Keratoplasty (LKP) can be a better choice to manage cases of moderate and some cases of severe Keratoconus without deep scarring and severe thinning, also in cases of corneal scarring not involving the deeper layers of the cornea. LKP is a corneal graft technique consisting of transplantation of partial-thickness donor tissue, devoid of endothelium, Descemet membrane (DM), and rear stroma into a recipient healthy stromal bed after dissection of pathologic anterior stroma. However, deep lamellar Keratoplasty (DLKP) is a surgical method that completely removes pathologic corneal stroma tissue down to the DM, followed by transplantation of donor cornea without endothelium over the host bed. DLKP has a number of advantages over penetrating Keratoplasty (PKP). Because it does not violate the intraocular structures of the eye, it diminishes or eliminates the chance of postoperative glaucoma, cataract formation, retinal detachment, cystoids macular edema, expulsive choroidal hemorrhage and epithelial ingrowths. Furthermore, this procedure avoids the replacement of host endothelium with donor endothelium and thus precludes endothelial graft rejection, with comparable visual outcomes and low rate of chronic endothelial cell loss compared to PKP.
圆锥角膜是一种导致角膜陡峭度增加并引起不规则散光的疾病。治疗选择包括眼镜、硬性隐形眼镜、交联、角膜基质环植入、屈光手术（吉尔达等人，2008年）或角膜移植术。板层角膜移植术（LKP）对于治疗中度圆锥角膜病例以及一些没有深层瘢痕和严重变薄的重度圆锥角膜病例，以及角膜瘢痕未累及角膜深层的病例可能是一个更好的选择。LKP是一种角膜移植技术，包括在切除病理性前基质后，将不含内皮、后弹力层（DM）和后部基质的部分厚度供体组织移植到受体健康的基质床中。然而，深板层角膜移植术（DLKP）是一种手术方法，它将病理性角膜基质组织完全切除至DM层，然后在宿主床上移植无内皮的供体角膜。与穿透性角膜移植术（PKP）相比，DLKP有许多优点。因为它不侵犯眼内结构，所以减少或消除了术后青光眼、白内障形成、视网膜脱离、黄斑囊样水肿、脉络膜出血和上皮内生的机会。此外，该手术避免了用供体内皮替代宿主角膜内皮，从而避免了内皮移植排斥反应，与PKP相比，视觉效果相当，慢性内皮细胞丢失率较低。
