Biomedical subjects
Klaus D Teichmann
Publications and source records attributed to Klaus D Teichmann.
Big-bubble technique to bare Descemet's membrane in anterior lamellar keratoplasty.
We describe a lamellar keratoplasty technique to bare Descemet's membrane in which air is injected to detach the central Descemet's. After a partial-thickness corneal trephination is performed, a disposable needle is inserted, deeply and bevel down, into the paracentral corneal stroma and air is injected. In most cases, this forms a large air bubble between Descemet's membrane and the corneal stroma. After anterior lamellar keratectomy is performed, a small opening is made in the air bubble and the remaining stromal layers are lifted with an iris spatula, severed with a blade, and excised with scissors. This technique is faster, safer, and easier to perform than previous methods.
Intravitreal injections: does globe size matter?
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Deep lamellar keratoplasty: surgical techniques for anterior lamellar keratoplasty with and without baring of Descemet's membrane.
PURPOSE: To review current techniques used in deep anterior lamellar keratoplasty (LKP), and to describe a novel approach that facilitates baring of Descemet's membrane (maximum depth anterior lamellar keratoplasty). METHODS: A highly selective review of the literature is presented, with descriptions of different techniques in the light of the authors' personal experience over 3 decades. A novel method for baring Descemet's membrane is detailed. It involves air injection in such a way that a large bubble is created between stroma and Descemet's membrane. Visual results of this operation in patients with keratoconus are reviewed. RESULTS: Visual results 6 months after maximum depth anterior LKP in 181 eyes with keratoconus are comparable with those resulting from penetrating keratoplasty: 89% achieved a best spectacle-corrected visual acuity of 20/40 or better, and 10% achieved 20/20 or better. Intraoperative perforation occurred in 9% of cases. CONCLUSIONS: Maximum depth anterior LKP has some important advantages when compared with other types of anterior lamellar keratoplasty or penetrating keratoplasty, but it remains a challenging procedure. A new technique considerably facilitates this operation and reduces intraoperative complications.
Reply to Deep lamellar keratoplasty as surgical management of anterior and posterior segment injuries to the eye.
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Age-related macular degeneration: comments on the articles by E.L. Altschuler and R.A. Weale.
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