A case of deep lamellar keratoplasty managed by a hooking technique for cicatricial corneal opacity due to luetic interstitial keratitis

Background : Deep lamellar keratoplasty (DLKP) techniques, due to their preservation of Descemet's membrane and the endothelium, have many advantages over penetrating keratoplasty. However, there are no standard methods for DLKP. We report a case in which we used a new hooking technique for DLKP. Case Report : A 68-year-old female visited Tohoku University Hospital with bilateral corneal opacity due to interstitial keratitis. On initial examination, her visual acuity was 0.03 in the right eye and counting fingers in the left eye. Four months later we performed DLKP using a hooking technique. A half-thickness incision was made with a 7mm trephine, followed by corneal lamellar incision. With microforceps, collagen fibers were moved aside and the surface between Descemet's membrane and the stroma was exposed. A donor corneal plug 7.25 mm in diameter was sutured in place with 10-0 nylon. Conclusion : The hooking technique we used for DLKP was an effective and safe approach for exposing the surface between Descemet's membrane and the stroma.