Ground-breaking method for corneal transplantation

A new method for corneal transplantation developed by Dr Cesar Carriazo, Centro Oftalmológico Carriazo, Colombia was presented at the recent ASCRS 2009 in San Francisco.

Developed as a result of a close and long-term cooperation with SCHWIND eye-tech-solutions the pachymetry assisted laser keratoplasty (PALK) is claimed to be an easy, safe and extremely precise procedure. It is suited for patients who need corneal transplants and whose endothelium is intact.

The PALK opens up new dimensions in corneal transplantation. A module of the SCHWIND-CAM software (PALK-CAM) available for the SCHWIND AMARIS laser precisely determines the ablation volume of the host cornea based on a detailed pachymetry map. At a high resolution in all dimensions, the SCHWIND AMARIS laser then ablates the calculated volume. This technique combines all advantages of lamellar keratoplasty, but additionally provides individualized corneal ablation ensuring homogeneity of residual stromal thickness, thus leading to better postsurgical visual results.

According to the clinical experience of Dr Carriazo gathered with preliminary software versions and in pilot studies, the treated eyes had an excellent transparency at the donor-host interface and most of them had less than 15% loss of endothelial cells. No rejection of the graft was observed. In addition, it was significantly better centred as compared to non-laser based techniques.

Contact-free method
Dr Carriazo said: "Patients improved their vision in both quantity and quality and additionally have the opportunity to more effective post-keratoplasty refractive corrections because with the PALK technique, they have gained extra corneal thickness and almost normal corneas in terms of anatomy. The risks are lower than those with the traditional technique, since the incidence of complications is very low." According to Dr Carriazo the major advantages of laser treatment with the PALK-CAM are the contact-free method without exerting mechanical pressure on the eye, the centring done by the eye tracking system, the minimal endothelial loss and the safety and reproducibility of the procedure, together with shorter surgical time with the SCHWIND AMARIS.

"Furthermore, the PALK technique preserves endothelium and Descemet membrane of the host, and survival is increased as compared to PKP. The possibility of rejection is minimal because the transplanted immune load is lower."