Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement

Editor,—We read with great interest the article by Sugita and Kondo and the editorial by Aggarwal.1 2 We congratulate the authors on this paper which can contribute to the revival of lamellar keratoplasty. The authors report on deep lamellar keratoplasty in which the stroma is excised to the extent that only Descemet’s membrane remained. We wish to comment that we have previously reported on a similar procedure.3-5 We used a full thickness graft, since in the eyes operated by us the endothelium was compensated and graft clarity was maintained by the donor’s corneal endothelium. It seems to us that deep lamellar keratoplasty with a full thickness graft can also be a useful procedure in cases with decompensated endothelium. 1. ↵ 1. Sugita J, 2. Kondo J (1997) Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement. Br J Ophthalmol 81:184–188. [OpenUrl][1][Abstract/FREE Full Text][2] 2. ↵ 1. Aggarwal RK (1997) Deep lamellar keratoplasty—an alternative to penetrating keratoplasty. Br J Ophthalmol 81:178–179. [OpenUrl][3][FREE Full Text][4] 3. ↵ 1. Lazar M, 2. Loewenstein A, 3. Geyer O (1991) Intentional retention of Descemet’s membrane during keratoplasty. Acta Ophthalmol 69:111–112. [OpenUrl][5][PubMed][6] 4. ↵ 1. Loewenstein A, 2. Geyer O, 3. Lazar M (1993) Intentional retention of Descemet’s membrane in keratoplasty for the surgical treatment of bullous keratoplasty. Acta Ophthalmol 71:280–282. [OpenUrl][7] 5. ↵ 1. Loewenstein A, 2. Lazar M (1993) Deep lamellar keratoplasty in the treatment of bullous keratopathy. Br J Ophthalmol 77:538. [OpenUrl][8][FREE Full Text][9] # Reply {#article-title-7} Editor,—I am pleased by the interest and debate generated by the editorial and also the paper by Sugita and Kondo. As mentioned in the editorial the concept of deep lamellar keratoplasty is not new. Its … [1]: {openurl}?query=rft.jtitle%253DBritish%2BJournal%2Bof%2BOphthalmology%26rft.stitle%253DBr%2BJ%2BOphthalmol%26rft.issn%253D0007-1161%26rft.aulast%253DSugita%26rft.auinit1%253DJ.%26rft.volume%253D81%26rft.issue%253D3%26rft.spage%253D184%26rft.epage%253D188%26rft.atitle%253DDeep%2Blamellar%2Bkeratoplasty%2Bwith%2Bcomplete%2Bremoval%2Bof%2Bpathological%2Bstroma%2Bfor%2Bvision%2Bimprovement%26rft_id%253Dinfo%253Apmid%252F9135380%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bjophthalmol&resid=81/3/184&atom=%2Fbjophthalmol%2F82%2F2%2F203.4.atom [3]: {openurl}?query=rft.jtitle%253DBritish%2BJournal%2Bof%2BOphthalmology%26rft.stitle%253DBr%2BJ%2BOphthalmol%26rft.issn%253D0007-1161%26rft.aulast%253DAGGARWAL%26rft.auinit1%253DR.%2BK%26rft.volume%253D81%26rft.issue%253D3%26rft.spage%253D178%26rft.epage%253D179%26rft.atitle%253DDeep%2Blamellar%2Bkeratoplasty---an%2Balternative%2Bto%2Bpenetrating%2Bkeratoplasty%26rft_id%253Dinfo%253Apmid%252F9135378%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/ijlink?linkType=FULL&journalCode=bjophthalmol&resid=81/3/178&atom=%2Fbjophthalmol%2F82%2F2%2F203.4.atom [5]: {openurl}?query=rft.jtitle%253DActa%2Bophthalmologica%26rft.stitle%253DActa%2BOphthalmol%2B%2528Copenh%2529%26rft.aulast%253DLazar%26rft.auinit1%253DM.%26rft.volume%253D69%26rft.issue%253D1%26rft.spage%253D111%26rft.epage%253D112%26rft.atitle%253DIntentional%2Bretention%2Bof%2BDescemet%2527s%2Bmembrane%2Bduring%2Bkeratoplasty.%26rft_id%253Dinfo%253Apmid%252F2028757%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/external-ref?access_num=2028757&link_type=MED&atom=%2Fbjophthalmol%2F82%2F2%2F203.4.atom [7]: {openurl}?query=rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: {openurl}?query=rft.jtitle%253DBritish%2BJournal%2Bof%2BOphthalmology%26rft.stitle%253DBr%2BJ%2BOphthalmol%26rft.issn%253D0007-1161%26rft.aulast%253DLoewenstein%26rft.auinit1%253DA%26rft.volume%253D77%26rft.issue%253D8%26rft.spage%253D538%26rft.epage%253D538%26rft.atitle%253DDeep%2Blamellar%2Bkeratoplasty%2Bin%2Bthe%2Btreatment%2Bof%2Bbullous%2Bkeratopathy.%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbjo.77.8.538%26rft_id%253Dinfo%253Apmid%252F8025058%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [9]: /lookup/ijlink?linkType=PDF&journalCode=bjophthalmol&resid=77/8/538&atom=%2Fbjophthalmol%2F82%2F2%2F203.4.atom