Automated anterior lamellar keratoplasty combines dermoid excision

Tag : Bandage Scissors

Measurements are taken in the vertical and horizontal axis of thelesion. Next, the lesion is well-demarcated using a Hannadisposable trephine (Moria), and partial trephination is carriedout (Figure 2). The conjunctiva and Tenon's are dissected using0.12 forceps and Westcott scissors to fully expose the limbaldermoid (Figure 3).

Hemostasis is achieved by using a disposablecautery. Maintaining proper plane of dissection is essentialthroughout the procedure. By blunt and sharp dissection, the limbaldermoid is fully excised (Figure 4).

The donor cornea is mounted within a Moria automated anteriorlamellar keratoplasty system, and the artificial anterior chamberis pressurized (Figure 5). A Moria CB microkeratome is used toexcise a lamellar disc of appropriate thickness to match the areaof tissue excision on the recipient ocular surface. The excisedlamellar disc is then placed in the well of a Hanna trephine, andusing the same trephine that was used to demarcate the lesion,trephination of the donor lamellar graft tissue is carried out.
 
Attachment of the donor corneal disc to recipient limbal region:Using sterile balanced salt solution, the stromal surface of thedonor corneal disc and the ocular surface of the patient's limbalarea are thoroughly rinsed to remove any debris that may otherwiseget trapped in the donor-recipient interface. The donor cornealdisc is then attached with a single 10-0 nylon suture and the discis flipped over to expose the stromal surface of the donor cornealdisc (Figure 6, on page 44).