Cataract Surgery Bonus Feature

NOVEMBER/DECEMBER 2010 CATARACT & REFRACTIVE SURGERY TODAY EUROPE 23 F ull-thickness penetrating keratoplasty (PKP) has been the preferred corneal transplantation technique since the procedure was first described in 1905 by Eduard Zirm.1 Today, PKP generally results in clear corneal grafts, with a graft survival rate of up to 72% at 5 years.2 However, the procedure is frequently complicated by refractive imperfections and wound healing problems. A significant number of patients may experience high irregular astigmatism and ametropia that cannot be optically rehabilitated with spectacles. Wound healing after PKP is often unstable and may lead to infection, vascularization, and wound dehiscence with risks for long-term graft survival. In 2005, the femtosecond laser was introduced to corneal transplantation surgery. This device is now used for lamellar and penetrating cut patterns and for posterior lamellar keratoplasty (PLK). Several endothelial keratoplasty (EK) procedures, including PLK, nonmechanical PLK using the femtosecond laser, deep lamellar endothelial keratoplasty (DLEK), Descemet’s stripping endothelial keratoplasty (DSEK), Descemet’s stripping automated endothelial keratoplasty (DSAEK), femtosecondassisted DSEK, and Descemet’s membrane endothelial keratoplasty (DMEK), allow selective replacement of the diseased endothelial layer, retaining the healthy recipient anterior corneal stroma. EK techniques result in rapid visual rehabilitation and minimal change in corneal astigmatism.3