Lamellar sclerokeratoplasty: review of the literature and description of a special technique using fibrin glue and a giant hydrophilic contact lens

Lamellar sclerokeratoplasty is a surgical procedure described since 1979 by Lim in China and reported by different surgeons in the world. Our purpose is to report a modified technique in which not only the whole cornea with a scleral rim is utilized, but the importance of including the whole Schlemm...

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Autores:
Arenas, Eduardo L.
Mieth, Alexandra
Tipo de recurso:
Fecha de publicación:
2019
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/2181
Acceso en línea:
http://hdl.handle.net/20.500.12495/2181
https://doi.org/10.4103/tjo.tjo_54_19
Palabra clave:
Procedimientos quirúrgicos operativos
Implantes de drenaje de glaucoma
Estudios de casos
Corneal transplant
Sclerokeratoplasty
Penetrating keratoplasty
Rights
License
Attribution-NonCommercial-ShareAlike 4.0 International
Description
Summary:Lamellar sclerokeratoplasty is a surgical procedure described since 1979 by Lim in China and reported by different surgeons in the world. Our purpose is to report a modified technique in which not only the whole cornea with a scleral rim is utilized, but the importance of including the whole Schlemm's canal area is also insisted; therefore, a new aqueous humor drainage pathway can be restored. The technique is designed for cases in which not only the whole cornea is decompensated, but also have untreatable glaucoma. This procedure replaces the entire anterior segment with a clear donor cornea including the limbus and part of the trabecular meshwork. We present the results of visual acuity by the logMAR scale of 55 cases from 110 patients receiving this surgical technique. The results describe 39 cases that had visual improvement after more than 1 year of follow-up and 16 cases that did not improve in their visual acuity. Large-diameter sclerokeratoplasty is an alternative and therapeutic option to eliminate the entire corneal pathology, while obtaining structural and even optical results with a lower immunological reaction. It can be considered an option in cases that are not suitable for standard grafting procedures. © 2019 Taiwan J Ophthalmol | Published by Wolters Kluwer-Medknow.