Sutureless femtosecond-assisted anterior lamellar keratoplasty may treat corneal pathologies

Selective corneal transplantation includes a variety of modern day surgical techniques to cater to two large categories: those with a healthy corneal endothelium and others with corneal endothelial decompensation. In the former group with a healthy corneal endothelium, an anterior lamellar keratoplasty may be chosen as the surgical technique, while in the latter group, a posterior lamellar keratoplasty technique such as endothelial keratoplasty may be used, which includes both Descemet’s stripping endothelial keratoplasty and Descemet’s membrane endothelial keratoplasty.ALK retains the posterior portions of the patient’s healthy cornea, including the corneal endothelium, thus affording the advantage of no corneal endothelial graft rejection following such surgical procedures. ALK may be divided into different procedures according to the John-Malbran classification: superficial ALK (160 µm), mid ALK (160 µm to 400 µm), deep ALK (470 µm to 495 µm) and total ALK (500 µm to 520 µm). The final quality of vision in ALK procedures is largely dependent on the type of donor-recipient corneal interface and the depth of this interface within the final surgically reconstructed cornea. In general, the deeper the corneal interface, the better the visual quality following the procedure.