Deep Anterior Lamellar Keratoplasty Over Penetrating Keratoplasty to Mitigate Positive Vitreous Pressure Complications

Khaled Moumneh; Scott Pollack; Larry M Perich

doi:10.7759/cureus.51120

Deep Anterior Lamellar Keratoplasty Over Penetrating Keratoplasty to Mitigate Positive Vitreous Pressure Complications

Cureus. 2023 Dec 26;15(12):e51120. doi: 10.7759/cureus.51120. eCollection 2023 Dec.

Authors

Khaled Moumneh¹, Scott Pollack², Larry M Perich³

Affiliations

¹ Ophthalmology, HCA Florida Bayonet Point Hospital, Hudson, USA.
² Ophthalmology, Pollack Eye Center, Buffalo, USA.
³ Ophthalmology, Perich Eye Center, New Port Richey, USA.

Abstract

This report describes deep anterior lamellar keratoplasty over penetrating keratoplasty (DALK-over-PKP) as an alternative technique to mitigate complications related to positive vitreous pressure (PVP) during PKP. We accomplished this by repairing the punctured cornea and performing a modified DALK where a full-thickness donor graft is placed over the host Descemet membrane, which is then removed after partial suturing of the graft. This mitigates the driving force behind the PVP by maintaining a closed-anterior chamber.

Keywords: combined surgical technique; cornea transplant; deep anterior lamellar keratoplasty; donor cornea; ophthalmology.