TY  - JOUR
AU  - Rossi, Costanza
AU  - Scorcia, Vincenzo
AU  - Borselli, Massimiliano
AU  - Giannaccare, Giuseppe
AU  - Spena, Rossella
AU  - Lucisano, Andrea
PY  - 2023
DA  - 2023/06/15
TI  - Surgical Tips for Improving Success Rate of Deep Anterior Lamellar Keratoplasty in Keratoconus
JO  - OBM Transplantation
SP  - 188
VL  - 07
IS  - 02
AB  - This article aims to provide some personal surgical tips to increase the success rate of deep anterior lamellar keratoplasty (DALK), a very advantageous yet complex procedure for treating keratoconus. The most troublesome surgical step is obtaining a successful pneumatic dissection of the deep stromal tissue, allowing the exposure of a deep cleavage plane. The following tips may aid the trainee surgeon in mastering this step, among others: performing a deep trephination, using intraoperative anterior segment optical coherence tomography and/or femtosecond laser, exploiting the red reflex after pupil dilation, using the ophthalmic viscoelastic device in case of bubble formation failure. Approaches for reducing postoperative astigmatism are employing large-diameter grafts and using intraoperative keratoscopy with digital ring analysis. In conclusion, different tips can shorten the DALK learning curve and help to obtain better results from this surgery. Standardizing this surgical technique is paramount to reduce "human errors" and broaden its range of applicability.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.2302188
DO  - 10.21926/obm.transplant.2302188
ID  - Rossi2023
ER  -