Limbal stem cell-sparing lamellar keratoplasty for the management of advanced keratoglobus.

PURPOSE To describe the technique and outcomes of limbal stem cell-sparing lamellar keratoplasty (LSCS-LKP) for the management of advanced keratoglobus (KGB). METHODS In a sequential interventional case series from March 2010 to December 2012, 8 eyes of 6 patients with advanced KGB underwent an LSCS-LKP. Three patients had isolated KGB, 2 were affected with the Ehlers-Danlos syndrome, and the other subject had osteogenesis imperfecta. Epithelial healing, anatomical results (corneal thickness and keratometry), and visual outcomes were evaluated after this intervention. RESULTS Three of the 6 patients were male. Complete epithelial healing occurred in 7 eyes during 2 weeks. Refractory persistent epithelial defect and graft melting occurred in 1 eye. Corneal thickness increased and central keratometry decreased after the LSCS-LKP was performed in all the patients. The patients were followed up for at least 6 months. Visual acuity improved in all eyes except 1. CONCLUSIONS LSCS-LKP is an effective procedure for preserving ocular integrity and for improving visual acuity in patients with advanced KGB. Early surgical intervention can be considered before the occurrence of vision-threatening traumatic corneal rupture.