Tectonic Lamellar Keratoplasty Utilizing a Microkeratome and an Artificial Anterior Chamber System

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Abstract
To describe a technique and report results of tectonic lamellar keratoplasty using tissue harvested with a microkeratome from a corneoscleral rim mounted in an artificial anterior chamber system. A donor lenticule was prepared from a corneoscleral rim utilizing the Moria LSK-1 (Moria/Microtek Inc., Doylestown, PA, U.S.A.) microkeratome and artificial anterior chamber. This tissue was used in the procedures of 6 eyes of 6 patients requiring tectonic lamellar keratoplasty. Three eyes were in danger of imminent perforation due to corneal ulceration. Other indications for lamellar engraftment include persistent wound leak following cataract extraction, persistent epithelial defect following a Grade 4 chemical burn, and limbal dermoid. A successful outcome, defined as restoration or preservation of globe integrity, vision, and intact epithelium, was achieved in all patients. Follow-up ranged from 2-8 months with a mean of 4.5 months. Donor lenticules prepared with the ALTK (Moria/Microtek Inc.) system can be used in the successful management of eyes requiring tectonic lamellar keratoplasty.