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B. Michael Walker, MD; Holly B. Hindman, MD; Katayoon B. Ebrahimi, MD; W. Richard Green, MD; Charles G. Eberhart, MD, PhD; Ivan Garcia, MD; Albert S. Jun, MD, PhD

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Corneal endothelial cell dysfunction is a common indication for penetrating keratoplasty.¹ Significant postoperative complications such as high astigmatism, suture breakage or infection, and graft dehiscence have led to the development of alternative surgical approaches for endothelial replacement. In 1999, Melles et al² reported a successful case of posterior lamellar keratoplasty in a human patient. This procedure was subsequently modified and renamed deep lamellar endothelial keratoplasty in 2001 by Terry and Ousley.³ Compared with penetrating keratoplasty, advantages of deep lamellar endothelial keratoplasty include reduced postoperative astigmatism with quicker visual recovery and a lower frequency of wound dehiscence and suture complications.^4-5 However, this procedure was slow to gain widespread acceptance owing in part to its technically demanding nature. Melles et al⁶ subsequently developed . . . [Full Text of this Article]

Report of a Case

Clinical History

Examination

In Vivo Confocal Microscopy

Histopathologic Examination

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