Daas Loay, Hamon Loïc, Ardjomand Navid, Safi Tarek, Seitz Berthold
Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrbergerstr. 100, Geb. 22, 66421, Homburg/Saar, Deutschland.
Sehzentrum für Augenlaser und Augenchirurgie, Graz, Österreich.
Ophthalmologe. 2021 Dec;118(12):1245-1248. doi: 10.1007/s00347-021-01342-3. Epub 2021 Feb 25.
The aim of excimer laser-assisted deep anterior lamellar keratoplasty (excimer-DALK) is, as in mechanical DALK, the treatment of keratectasia (keratoconus and pellucid marginal degeneration), stromal scars or stromal corneal dystrophy. A prerequisite for surgery is the absence of (pre‑) Descemet's scars and an intact endothelium.
After excimer laser-assisted trephination to 80% of the corneal thickness at the trephination site, intrastromal air injection (so-called big bubble) and lamellar corneal preparation, a lamellar anterior transplantation of the endothelium-free donor tissue is performed. The technique combines the advantages of DALK and excimer laser trephination. We describe the steps of an excimer-DALK from the Homburg Keratoconus Center (HKC).
Excimer-DALK is a viable treatment option for patients with intact endothelium. In cases of intraoperative perforation, conversion to excimer-perforating keratoplasty (PKP) with all the advantages of excimer laser trephination remains feasible.
与机械性深板层角膜移植术（DALK）一样，准分子激光辅助深板层角膜移植术（excimer-DALK）的目的是治疗角膜扩张症（圆锥角膜和透明边缘变性）、基质瘢痕或基质性角膜营养不良。手术的一个前提条件是不存在（前）Descemet膜瘢痕且内皮完整。
在准分子激光辅助下于环切部位将角膜厚度切至80%，进行基质内空气注射（所谓的大泡）和板层角膜制备后，进行无内皮供体组织的板层前移植。该技术结合了DALK和准分子激光环切的优点。我们描述了洪堡圆锥角膜中心（HKC）的excimer-DALK手术步骤。
对于内皮完整的患者，excimer-DALK是一种可行的治疗选择。在术中穿孔的情况下，转换为准分子穿透性角膜移植术（PKP）并保留准分子激光环切的所有优点仍然可行。
