الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 144 |  |  |
| | | from | 144 | | |
Abstract
Endothelial dysfunction remains the leading indication for penetrating
keratoplasty (PK) in the United States. More than half of the nearly 40 000
corneal transplants performed each year Are to treat either Fuchs corneal
endothelial dystrophy or pseudopbakic bullous keratopethy, In the past,
endothelial replacement ’NaS accomplished by PK. Pioneered by Melles et al
in 1997; posterior lamellar keratoplasty {PLK) advanced the treatmentof
corneal endothelial dysfunction (fuchs’ and bullous keraropathy) by
eliminating the n meNUS weaknesses of the standard procedure, penetrating
keratoplasty (PK). These flaws included prolonged visual recovery, induced
irregular and regular astigmatism, and the long-term risk of traumatic wound
rupture,
Terry and Ousley in 2000, developed new instrumentation and renamed
PLK as deep lamellar endothelial keratoplasty (DLEK). Their report On their
first 32 patients yielded generally excellent visual results. Mel1es in 2002
moved the incision from the superior limbus to the temporal cleer cornea,
which reduced the incision size from. 9 to 5 rnm. However, these
modifications did not reduce the technical skill and time required for smooth
manual . tromal dissections on both patient and donor. Melles in 2004, further
modified his procedure ina cadaver model by replacing the patient stromal
dissection with a Descemet-stripping technique.
111.eDescemet’s stripping automated endothelial keratoplasty (DSAEK)
modification advances this technique (DSEK) by replacing the manual
stromal di section On the donor cornea with a keratome dissection. This
method avoids all manual lamellar dissections and bas the potential to result
in a smoother interface. Improvement in the interface may decrease visual
recovery time and increase visual quality. I.