Surgical Technique of Deep Anterior Lamellar Keratoplasty in Descemetoceles

PURPOSE: To describe a surgical technique of deep anterior lamellar keratoplasty (DALK) to treat patients with descemetocele. METHODS: Twelve eyes of 12 patients with central or paracentral descemetocele after resolved microbial keratitis underwent viscoelastic-assisted DALK. The mean follow-up of the cases was 19.91 ± 15.80 months (range: 6-48 months). RESULT: In all the eyes, a successful DALK could be performed without any intraoperative complications. At the last follow-up visit, all but 1 eye showed significant improvement in visual acuity compared with preoperative visual acuity. The postoperative best-corrected visual acuity did not improve in 1 patient because of glaucomatous optic atrophy, which was present preoperatively. Eight eyes had best-corrected visual acuity of ≥ 20/80, and all but 2 patients had clear grafts at the final follow-up. None of the patients had any evidence of graft infection. CONCLUSIONS: Viscoelastic-assisted DALK is a useful therapeutic option in selected cases of descemetocele after resolved microbial keratitis.