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    When it comes to lamellar surgery, a bevy of options

    San Diego—With the influx of numerous endothelial keratoplasty procedures, only 15% of corneal transplants last year were penetrating keratoplasty (PK), said Donald T.H. Tan, MD, Singapore.

    “We need to seek alternative technologies for lamellar dissection,” he said. “It’s not just the art—we need to go back to the technology.”

    In case you missed it: Why you should consider Phakic IOLs for correcting myopia

    Dr. Tan presented the Binkhorst Lecture during the opening general session at the 2015 meeting of the American Society of Cataract and Refractive Surgery.

    “This is a truly tremendous honor and privilege,” Dr. Tan said, who dedicated the talk to the “giants and champions who are changing the field of corneal transplantation.”

    To that end, Dr. Tan is introducing for the first time at this conference a patent-pending piezo-electric corneal knife.

    “This is already in wide use in cataract surgery,” he said.

    The high-frequency ultrasound fragments the cataract and features a blunt dissector. Using that technology, the vibration will separate the corneal layers so that the second dissected layer is only 30 μm.

    The Singapore Corneal Transplant Study—which comprised 2,300 transplants followed for the more than 12 years—found that after the first year, graft survival was about the same for PK, deep anterior lamellar keratoplasty (DALK), and Descemet’s stripping automated endothelial keratoplasty (DSAEK). However, by years 3 and 5, DALK started to show better longevity.

    Next: Why are more countries not adopting these procedures?

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