Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy.

Abstract

To describe a new surgical technique for posterior corneal transplantation. An elderly patient had painful, pseudophakic bullous keratopathy with low visual potential. Through a 9.0-mm scleral tunnel incision, a midstromal pocket was dissected across the cornea, and a posterior lamellar disk 7.0-mm in diameter, which consisted of posterior stroma, Descemet membrane, and endothelium, was excised. A similarly shaped donor posterior disk was implanted in the recipient opening without suture fixation, and the scleral incision was sutured. Throughout the postoperative period, the posterior corneal transplant remained clear and in position. Three months after surgery, the "suture-in" astigmatic error was 3.5 diopters. Pachymetry measured 0.44 mm. Posterior lamellar keratoplasty may be a new surgical approach with which to manage corneal endothelial disorders.