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[Excimer laser-assisted DALK: a case report from the Homburg Keratoconus Center (HKC)].


ABSTRACT:

Indications

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.

Surgical technique

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).

Conclusion

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.

SUBMITTER: Daas L 

PROVIDER: S-EPMC8648704 | biostudies-literature |

REPOSITORIES: biostudies-literature

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