Aktuelle Tagungsinformationen
News and Updates
Anmeldung zur Tagung
Registration
Hotelbuchung
Hotel Registration
Grußwort
Welcome address
Beteiligte Gesellschaften
Societies involved
Eröffnung des Kongresses
Opening Ceremony
Preise
Awards
Wissenschaftliches Programm
Scientific program
Posterpräsentationen
Poster Presentation
Kurse
Courses
Begleitende Veranstaltungen
Collateral Events
Rahmenprogramm
Social program
Jubiläumsparty
Jubilee Party
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
DOG Homepage
Excimer Laser Assisted Penetrating Keratoplasty
Seitz B., Langenbucher A., Küchle M., Naumann G. O. H.,
Friedrich-Alexander-Universität, Augenklinik (Erlangen)
Purpose: To demonstrate the background, technique and advantages of nonmechanical corneal trephination using the excimer laser for penetrating keratoplasty (PK).
Patients and Methods: Hypothesising that the properties of the wound bed are of utmost importance for the final optical performance of the graft we have developed and optimized the technique of nonmechanical corneal trephination along metal masks with eight "orientation teeth/notches". Since 1989 more than 1200 eyes have been treated successfully with the Meditec MEL60Ò excimer laser. For donor trephination from the epithelial side an artificial anterior chamber was used.
Results: Published clinical studies have shown that this technique may improve donor and recipient centration, reduce "vertical tilt" and "horizontal torsion" of the graft in the recipient bed, thus resulting in significantly less "all-sutures-out" astigmatism, higher regularity of the topography and better visual acuity. Besides less blood-aqueous barrier breakdown during the early postoperative course after PK, laser trephination does not induce cataract formation and does not impair the graft endothelium. Likewise, the rate of immunologic graft rejections is not adversely affected by laser trephination and trephination of an instable cornea, such as in (pre-) perforated corneal ulcers or after RK or LASIK is facilitated.
Conclusions: Postkeratoplasty results seem to be superior using nonmechanical excimer laser trephination. Thus, this methodology is recommended as the procedure of first choice in avascular corneal pathologies requiring PK.