Modern Keratoplasty

​Keratoplasty techniques have evolved in the last 15 years into a variety of forms, which have diversified the previous monographic presence of the penetrating keratoplasty technique. The development of anterior lamellar graft (DALK), and posterior lamellar graft (DSAEK), makes an important change in the approach to lamellar surgery. Later on, the appearance of DMEK and superficial lamellar keratectomy broadened the spectrum. Today, intralamellar surgery has evolved with a number of techniques that involve stromal enhancement with biologically active or acellular corneal laminas from donors, customized lenticles from SMILE surgeries or customized by corneal topography, and more recently, corneal regeneration of the stroma by advanced techniques using mesenchymal stem cells. This book offers a comprehensive overview of modern keratoplasty techniques, the technology, surgical skills, and outcomes. It highlights the practical uses of keratoplasty for all cornea surgeons and anterior segment surgeons. The book is divided into sections, each covering a specific type of keratoplasty, including chapters on innovations within each surgery type. The goal of this book is to unify all recent knowledge about the different keratoplasty techniques and outcomes, creating a one-stop resource for ophthalmaolgy surgeons. Modern Keratoplasty is a must-have resource for corneal specialists and surgeons, anterior segment surgeons, refractive surgeons, cataract surgeons, residents, fellows, and corneal researchers.

Thus this book impressively reflects many years of surgi A successful penetrating keratoplasty has many prerequi sites, for example suitable donor tissue, careful harvesting cal experience and can impart this to younger operating v of the donor eye and donor cornea, the possibility of suit surgeons and many colleagues who assist in the care of able short-term conservation, an atraumatic transplant the patients. technique using modern corneoscleral trephination instru Since the key to long-term visual rehabilitation of kerato ments as well as a problem-orientated perioperative phar plasty patients can be found in the knowledge presented macotherapy. All of these factors contribute to the here, we hope this book will enjoy the largest possible cir immediate success of the operation. More decisive for the culation. long-term success of the transplant and therefore more One is unable to conclude this preface without a word of thanks from the Department of Ophthalmology of the Uni important for the patient is, however, the early recognition versity of Cologne to the author for the many years during of immunogenic and non-immunogenic complications which she directed the keratoplasty consultation service. from the moment of the patient's discharge from hospital. In view of the multitude of interactions between the recipi These thanks are also in the name of our patients who ent eye and the donor cornea there is a complex spectrum benefited from her expert care.

As a degenerative disorder of the eye, keratoconus can cause substantial distortion of vision, with multiple images, streaking, and sensitivity to light all reported by patients. Keratoconus: Recent Advances in Diagnosis and Treatment updates ophthalmologists about the innovations that have occurred within the last decade, discussing the diagnostic imaging techniques that have been developed for keratoconus diagnosis, understanding of how examination techniques are related to the evolution of keratoconus, and how to indicate the different therapeutic tools that have been created for keratoconus over the last several years. Additionally, fundamentals for new diagnostic elements, based on the mathematical, physical and biomechanical data are analyzed in depth for a better understanding of the essential diagnostic steps for the clinician to guide patients towards the most adequate therapeutic tool in the case. Modern keratoplasty techniques, assisted by femtosecond lasers or other devices, are also covered and these techniques, along with the emerging conservative treatments, have added to more precise control of the evolution of the disease.

"DSEK: What You Need to Know About Endothelial Keratoplasty provides a comprehensive background of EK, where it is today, and where it is headed in the future. Francis W. Price, MD. who was the first to complete DSEK in the United States, along with Marianne Price, PhD, have designed this text to offer a special emphasis on how to perform surgeries along with preventing and managing complications. In addition, a diverse group of contributing authors provides a wide array of insights and tips for better patient outcomes."--BOOK JACKET.

Deep anterior lamellar keratoplasty (DALK) is the mainstay of treatment for corneal pathologies sparing the endothelium. This lamellar surgery has undergone a revolution in the past decades. Various techniques and their modifications have been described to make it safe and reproducible so that it can be performed not only by experts but also the novice corneal transplant surgeons. This book describes the evolution of DALK, indications, preoperative evaluation, the various methods of performing DALK and the postoperative outcomes. The issues related to procurement of donor corneas for such cases are discussed. The "different strokes" in DALK include the conventional Melles and the "Big bubble" technique and also the newer modifications such as "Double bubble" technique, cannula assisted DALK, groove and peel technique as well as diamond blade-guided DALK. The different types of modifications presented by eminent lamellar corneal transplant surgeons from all over the world, in this book are an endeavor to make DALK feasible by all corneal transplant surgeons.

Corneal transplantation is a widely practised surgical procedure. Lamellar techniques are favoured replacing penetrating keratoplasty (PK). Endothelial keratoplasty (EK) has been adapted as an alternative in the treatment of corneal endothelial disorders whereby Descemet’s membrane and the endothelium are replaced. Pre-Descemet’s endothelial keratoplasty (PDEK) is the latest surgical technique for corneal transplantation. This book is a step by step guide to PDEK for practising ophthalmologists. Divided into five sections, the text begins with the basics explaining corneal anatomy, pre-operative assessment, general techniques in keratoplasty, and the principles of PDEK. The following chapters discuss surgical techniques, special situations, and complications and results. The text covers numerous clinical scenarios and concludes with a section on miscellaneous topics such as OCT guided PDEK, eye bank preparation, and cosmetic iris implant complications. The text is further enhanced by surgical photographs and includes an interactive DVD ROM demonstrating PDEK techniques. Key points Step by step guide to Pre-Descemet’s endothelial keratoplasty (PDEK) Explains surgical techniques for numerous clinical scenarios Includes miscellaneous topics such as OCT guided PDEK and cosmetic iris implant complications Accompanying DVD ROM demonstrates PDEK techniques

State-of-the-art book provides hands-on guidance on the latest endothelial keratoplasty techniques A significant number of eye disorders result from deficiencies in the endothelial layer of the cornea. Endothelial keratoplasty (EK) helps spare patients from months of refractive adjustments, lengthy recovery, complications, and poor outcomes associated with full-thickness penetrating keratoplasty. This newer methodology is based on more selective transplantation of cells and is less invasive, resulting in quicker recovery and more efficacious outcomes. Contributors are world-renowned pioneers who are front and center in implementing innovative, sight-restoring techniques that continue to change the ophthalmic surgery landscape. In the first section, a solid foundation is laid with discussion of anatomy, the history of EK, clinical aspects of endothelial cell dysfunction, and clinico-pathology. Subsequent sections cover surgical procedures, special topics, surgical outcomes, complications, and future trends. Readers will gain invaluable insights from clinical pearls throughout the book, gleaned from hands-on experience by leading experts in the field of ocular surgery. Key Features: A large compendium of high-quality videos demonstrate cutting-edge approaches Richly illustrated with 400 images that further delineate anatomy and techniques Anterior segment surgery advances including Descemet's stripping endothelial keratoplasty (DSEK), predescemet's endothelial keratoplasty (PDEK), ultrathin DSEK, Descemet's membrane endothelial keratoplasty (DMEK), and trocar anterior chamber maintainer Treatment of conditions such as pseudophakic bullous keratopathy and Fuchs' dystrophy Management of complicated cases including glued IOL, cataract extraction & IOL implantation, glaucoma, failed grafts, and scarred corneas This book is a stellar resource on the surgical management of patients with corneal disease. It will benefit both trainees and practicing ophthalmologists - and is a must-have for specialists who perform corneal surgery.

Volume 2 of this edited book covers management of complex situations and complications. Topics such as combined surgeries, EK in complex situations, management of complications, graft management, and RHO-associated kinase (Rock) inhibitors have been covered as well. Basics and various surgical techniques have been covered in Volume 1 of Mastering Endothelial Keratoplasty. Endothelial keratoplasty is a field of great interest to all corneal surgeons. It is an exciting and evolving field in corneal transplantation as the newer techniques of DSAEK, DMEK, E-DMEK and PDEK have inherent advantages that make them supersede the older techniques by far. Hence, in today's scenario with the clearly superior results that these techniques offer, it is imperative for all corneal surgeons to learn them and know everything about managing the patient from the pre-operative to the postoperative period. This two-volume book is a must-read for the beginner as well as the established ophthalmologist with interest in corneal transplantation. It is also a must-have for educational institutions, hospital- based libraries and for post-graduate students, fellows and residents who want to expand their knowledge.

This book provides state of the art information on modern minimally invasive lamellar transplant techniques for Fuchs endothelial dystrophy (FED), such as Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). In addition to clear step-by-step descriptions of procedures, guidance is offered on donor tissue preparation, potential intra- and postoperative complications, and complication management. Future treatment options in the form of medical, cell-based approaches are also discussed. To complete the picture, relevant information is included on the pathophysiology, clinical features, and differential diagnosis of FED. This book will be of interest to all who wish to learn about the dramatic developments in corneal transplantation and medical treatment that are transforming the management of FED.