"Groove and Peel" Deep Anterior Lamellar Keratoplasty: How Deep Can You Go?. Issue 1 (10th January 2023)

• Record Type: Journal Article
• Authors: Son, Hyeck-Soo; Rigi, Mohammed; Srikumaran, Divya; Eberhart, Charles G.; Jun, Albert S.; Soiberman, Uri S.
• Is Part Of: Cornea. Volume 42:Issue 1(2023)
• Page Start: 105
• Page End: 109
• Publication Date: 2023-01-10
• Subjects: manual DALK, groove and peel, corneal transplantation, corneal thickness; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000003103
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract : Purpose: The aim of the current research was to measure the thickness of the residual central corneal bed after performing the manual "Groove and Peel" deep anterior lamellar keratoplasty (GP-DALK) technique on human cadaveric eyes. Methods: The manual GP-DALK technique was performed on 6 human cadaver eyes by an experienced corneal surgeon. After surgery, the eye globes were fixed in 10% buffered formalin and embedded in paraffin. For each eye, 4-μm-thick hematoxylin and eosin sections involving the pupillary axis were obtained and examined. Using an image-processing software, 2 observers measured the corneal thickness of the residual central corneal bed and the peripheral corneal rims. Results: The overall mean central corneal bed thickness was 35.5 ± 12.9 μm, whereas the mean right and left peripheral rim thicknesses were 993.0 ± 141.1 and 989.3 ± 147.1 μm, respectively ( P = 0.0006 ). In most corneas, the level of dissection reached almost to the pre-Descemetic collagen (Dua) layer. Conclusions: The GP-DALK technique is effective in removing most of the corneal stroma and may be non-inferior to "big-bubble" deep anterior lamellar keratoplasty in some cases.