Sutureless Homoplastic Lamellar Keratoplasty

BACKGROUND: Previously, penetrating keratoplasty has been used to treat corneal cap complications related to keratomileusis. We sought to develop a technique to avoid the unnecessary use of penetrating procedures for lamellar problems, that would be technically easier than standard lamellar keratoplasty--sutureless homoplastic lamellar keratoplasty. METHODS: Five eyes with complications from automated lamellar keratoplasty underwent sutureless homoplastic lamellar keratoplasty utilizing an automated microkeratome and topical anesthesia. RESULTS: Three of the five eyes had improved vision; two eyes with final visual acuities of 20/20 and 20/30. The two remaining eyes had poor host stromal beds and required penetrating keratoplasty. The mean follow-up time was 13 months (range 3 to 36 months). All lamellar grafts were clear and well-seated at the last postoperative examination. CONCLUSION: Sutureless homoplastic lamellar keratoplasty is an alternative to penetrating keratoplasty in some eyes that have cap-related problems.