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KERATOPLASTIES – SURGICAL TECHNIQUES AND COMPLICATIONS

Edited by Luigi Mosca

Keratoplasties – Surgical Techniques and Complications

Edited by Luigi Mosca

Published by InTech

Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2011 InTech

All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source.

As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications.

Notice

Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book.

Publishing Process Manager Dragana Manestar

Technical Editor Teodora Smiljanic Cover Designer InTech Design Team

Image Copyright lavitrei, 2011 Used under license from Shutterstock.com

First published December, 2011

Printed in Croatia

A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org

Keratoplasties – Surgical Techniques and Complications, Edited by Luigi Mosca p. cm.

ISBN 978-953-307-809-0

free online editions of InTech

Books and Journals can be found at www.intechopen.com

Contents

 

Preface IX

 

 

 

Part 1

Penetrating Keratoplasty

1

 

 

Chapter 1

Clinical Indications for Penetrating Keratoplasty

 

 

and Epidemiological Study in Teaching Hospitals

 

of Birjand Medical University from 1999 to 2006

3

 

Mohammad Hossien Davari and Hoda Gheytasi

 

 

Chapter 2

Therapeutic Keratoplasty for Microbial Keratitis

11

 

Ana Lilia Pérez-Balbuena, Diana Santander-García,

 

 

 

Virginia Vanzzini-Zago and Diego Cuevas-Cancino

 

 

Chapter 3

Keratoplasty in

 

 

 

 

Contact Lens Related Acanthamoeba Keratitis

 

31

 

Beata Kettesy, Laszlo Modis Jr.,

 

 

 

Andras Berta and Adam Kemeny-Beke

 

 

Part 2

Lamellar Keratoplasties

53

 

 

Chapter 4

Manual Deep Anterior Lamellar Keratoplasty

55

 

Farid Daneshgar

 

 

 

Chapter 5

Femtosecond Laser Assisted Lamellar Keratoplasties 77

 

Luigi Mosca, Laura Guccione, Luca Mosca,

 

 

 

Romina Fasciani and Emilio Balestrazzi

 

 

Chapter 6

Descemet’s Stripping with Automated

 

 

 

Endothelial Keratoplasty (DSAEK) in Patients

 

 

 

with Black Diaphragm Intraocular (BDI) Lens

93

 

Hui-Jin Chen, Yan-sheng Hao and Jing Hong

 

 

Part 3

Complications of Keratoplasties 99

 

 

Chapter 7

The Complications After Keratoplasty 101

 

 

 

Patricia Durán Ospina

 

 

 

VI Contents

Chapter 8 Diagnosis and Treatment

of a Rare Complication After Penetrating Keratoplasty: Retained Descemet’s Membrane 119

Roberto Ceccuzzi, Gabriella Ricciardelli, Annita Fiorentino, Meri Tasellari, Giovanni Furiosi and Paolo Emilio Bianchi

Chapter 9 Topical Bevacizumab Therapy

in Graft Rejection After Penetrating Keratoplasty 127

Sandeep Saxena and Neha Sinha

Preface

The practice of this subspecialty in ophthalmology diversifies each day, and grows with new surgical techniques and therapeutic approaches to corneal pathologies. This book on keratoplasties, divided into three sections, may perhaps seem too undemanding to some, but all the new therapeutic and surgical techniques are well approached in these chapters.

The long-lasting penetrating keratoplasty (PK) technique has shown to have good results, both anatomical and optical, leading to better visual outcomes despite other keratoplasty techniques, maintaining its place in corneal transplant surgery until today, especially in cases of infectious disease of the cornea. Moreover, for a long time, PK relegated lamellar keratoplasty (LK) techniques to primarily tectonic indications due to poor visual results. The development of new technologies (diamond knives, microkeratomes, lasers) and the creation of new surgical techniques (descemeting and predescemeting techniques) leading to better interfaces, have given a new impulse to lamellar keratoplasty surgery in the last years. Deep anterior lamellar keratoplasty (DALK) and the Descemet stripping endothelial keratoplasty (DSEK), less invasive and equally effective both in anatomical and visual outcomes, are the leading techniques for most corneal pathologies in preference to the PK today.

This edition is in an electronic format, allowing universal access to everybody regardless of the time of day or setting, portability, and speed of information access. Such features help to reduce the time needed for research, showing more feasibility for all readers.

The main purpose of this book is to show the different therapeutic and surgical techniques to treat corneal pathologies, as well as analyzing the postoperative complications of the different treatments.

I hope that this book can serve as a good tool to all students approaching the field of corneal transplantation, and to all practitioners working in the field of corneal transplantation as a contribution to improvement in care for patients with corneal disease.

Luigi Mosca, MD

Catholic University “Sacro Cuore”, Rome,

Italy