EDITORIAL The Taming of the Shrew ORNEAL TRANSPLANT SURGERY HAS BEEN Regarding strategies to optimize and standardize tis- revolutionized in recent years. Whereas sue preparation, efforts are ongoing to prepare precut tis- full-thickness penetrating keratoplasty sue for use by surgeons who do not prepare the tissue has been the standard way of treating dis- themselves. In addition, efforts are under way to opti- C eased corneas for over 100 years, recent mize and standardize the preoperative splitting of tissue advances in lamellar corneal surgery have opened up the and to optimize the conditions for prolonged storage of 7-9 way toward minimally invasive and selective corneal trans- split cornea parts for use in DMEK and DALK. Several plant surgery. attempts have already been made to standardize the tech- Deep anterior lamellar keratoplasty (DALK) now al- nique in a fashion similar to that for DSAEK. lows for selective replacement of anterior stroma in stro- With DMEK, the difficult steps are primarily the care- mal dystrophies and keratoconus without replacing the ful unfolding and attaching of the graft. The article by healthy Descemet membrane and endothelium. Accord- Liarakos et al, along with an online video demonstrat- ing to a recent technology assessment
JAMA Ophthalmology – American Medical Association
Published: Jan 1, 2013
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