Sutureless homoplastic lamellar keratoplasty.

BACKGROUND Previously, penetrating keratoplasty has been used to treat corneal cap complications related to keratomileusis. We sought to develop a technique to avoid the unnecessary use of penetrating procedures for lamellar problems, that would be technically easier than standard lamellar keratoplasty--sutureless homoplastic lamellar keratoplasty. METHODS Five eyes with complications from automated lamellar keratoplasty underwent sutureless homoplastic lamellar keratoplasty utilizing an automated microkeratome and topical anesthesia. RESULTS Three of the five eyes had improved vision; two eyes with final visual acuities of 20/20 and 20/30. The two remaining eyes had poor host stromal beds and required penetrating keratoplasty. The mean follow-up time was 13 months (range 3 to 36 months). All lamellar grafts were clear and well-seated at the last postoperative examination. CONCLUSION Sutureless homoplastic lamellar keratoplasty is an alternative to penetrating keratoplasty in some eyes that have cap-related problems.