What Is a Lamellar Keratoplasty?

Lamellar keratoplasty is an optical procedure that entails removing the majority of a person's cornea and replacing it with material from a donor to enhance the refractive power of the cornea. The procedure is performed under local anesthesia by an ophthalmologist and involves repairing the diseased middle and second layers of the cornea in individuals suffering from extreme nearsightedness or farsightedness. Lamellar keratoplasty may be performed to correct thinning to a person's cornea as well. The surgery may take up to three hours and generally improves an individual's vision.

Prior to lamellar keratoplasty, a patient will be evaluated by an ophthalmologist. The eye specialist will take measurements including pupil size and thickness of the cornea. In addition, the ophthalmologist will conduct a thorough examination of the cornea. If a patient wears contact lenses, he or she may be required to refrain from wearing them for days or weeks prior to surgery, depending on the prescription.

During the procedure, an ophthalmologist will use a device to indicate which portions of the cornea that need to be taken out. The ophthalmologist will then remove the unhealthy tissues while keeping the deeper portion of the cornea intact. The unhealthy tissue is then replaced with similar-size portion of tissue from a donor and sutured into the patient's cornea. After the surgery, dressing is placed over the region.

Lamellar keratoplasty does not involve cutting through a patient's cornea completely, lowering the risk of infection. Aa cornea possesses no blood vessels, however, and healing time is slow, which can lead to microorganisms entering the eye. Antibiotic eye drops are generally prescribed after the surgery to prevent any infections and curb irritation. During the procedure, some minor blood loss may occur during the suturing.

After the donor material has been attached, eventually new host cells will grow over the surface of the patient's cornea. Healing time from the procedure itself may be less than a day. The patient's vision may take several weeks to stabilize, however.

Rejection of the transplanted materials of the cornea is a possibility after lamellar keratoplasty. A patient may reject the donated material even years after the surgery. However, since lamellar keratoplasty is not an entire corneal transplant and does not affect the endothelium, the portion of the cornea responsible for pumping fluid in the inner eye, the risk of rejection is fairly remote. Other possible complications from the surgery may also include scarring of the cornea and the inability to wear corrective lenses.