Stromal Peeling for DALK in Post-PK Eyes

Corneal stromal disease can recur years after an uneventful penetrating keratoplasty (PK) and significantly impair vision, necessitating repeat surgery. Because the survival of a full-thickness graft decreases after every successive repeat PK, an optimal technique would selectively remove diseased stroma during the re-grafting procedure. Dr. Cristina Bovone and colleagues demonstrate how a stromal exchange can be performed by simple peeling, without deep anterior lamellar keratoplasty (DALK) dissection of the previous PK graft. Postoperative changes in stromal microarchitecture allow stromal peeling along a natural plane of separation.

Associated video authors: Drs. Angeli Christy Yu and Massimo Busin