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بسم الله الرحیمن الرحیم Contra-indication of DALK

بسم الله الرحیمن الرحیم Contra-indication of DALK. Mohammad Reza Jafarinasab Labbafinejad Medical Center. Anterior Approach Keratoplasty. LK DLK PK. Anterior Lamellar Keratoplasy(ALK) manual dissection techniques Microkeratome Assisted Anterior Lamellar Keratoplasty

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بسم الله الرحیمن الرحیم Contra-indication of DALK

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  1. بسم الله الرحیمن الرحیمContra-indication of DALK Mohammad Reza Jafarinasab Labbafinejad Medical Center

  2. Anterior Approach Keratoplasty • LK • DLK • PK

  3. Anterior Lamellar Keratoplasy(ALK) manual dissection techniques Microkeratome Assisted Anterior Lamellar Keratoplasty Laser Assisted Anterior Lamellar Keratoplasty

  4. Deep Anterior Lamellar Keratoplasy (DALK) Deep stromal manual dissection techniques Dry stromal layer-by-layer manual dissection Air guided deep stromal dissection Deep intracorneal dissection Descemet’s membrane baring techniques

  5. Descemet’s membrane baring techniques Big-Bubble technique Viscoelastic dissection technique Descemet’s membrane dyeing technique

  6. Indications • The big Bubble technique is only used for conditions where the endothelium is healtly and there are no previous breaks in the DM. the goal is to expose DM. the following are the indications. • Corneal ectatic disorders: a. keratoconus b. Pellucid marginal degeneration c. keratoglobus d. keratectasia following refractive surgery (lASIK,PRK ) 2. Stromal opacities and scars sparing DM. 3. Corneal dystrophies of anterior/ deeper stroma.

  7. contra-indication Diseased endothelial cells Previous rupture in DM (hydrops) Deep scars, however small, involving D.M Macular corneal dystrophy is a relative contra-indication because the DM is usually fragile.

  8. Trachoma Keratopathy

  9. Trachoma Keratopathy

  10. Lattice Corneal Dystrophy

  11. Macular Corneal Dystrophy

  12. Mustard Gas Keratopathy

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