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KERATOPLASTIES – SURGICAL TECHNIQUES AND COMPLICATIONS Edited by Luigi Mosca Keratoplasties – Surgical Techniques and Complications Edited by Luigi Mosca Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Dragana Manestar Technical Editor Teodora Smiljanic Cover Designer InTech Design Team Image Copyright lavitrei, 2011 Used under license from Shutterstock.com First published December, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from [email protected] Keratoplasties – Surgical Techniques and Complications, Edited by Luigi Mosca p. cm. ISBN 978-953-307-809-0 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Penetrating Keratoplasty 1 Chapter 1 Clinical Indications for Penetrating Keratoplasty and Epidemiological Study in Teaching Hospitals of Birjand Medical University from 1999 to 2006 3 Mohammad Hossien Davari and Hoda Gheytasi Chapter 2 Therapeutic Keratoplasty for Microbial Keratitis 11 Ana Lilia Pérez-Balbuena, Diana Santander-García, Virginia Vanzzini-Zago and Diego Cuevas-Cancino Chapter 3 Keratoplasty in Contact Lens Related Acanthamoeba Keratitis 31 Beata Kettesy, Laszlo Modis Jr., Andras Berta and Adam Kemeny-Beke Part 2 Lamellar Keratoplasties 53 Chapter 4 Manual Deep Anterior Lamellar Keratoplasty 55 Farid Daneshgar Chapter 5 Femtosecond Laser Assisted Lamellar Keratoplasties 77 Luigi Mosca, Laura Guccione, Luca Mosca, Romina Fasciani and Emilio Balestrazzi Chapter 6 Descemet’s Stripping with Automated Endothelial Keratoplasty (DSAEK) in Patients with Black Diaphragm Intraocular (BDI) Lens 93 Hui-Jin Chen, Yan-sheng Hao and Jing Hong Part 3 Complications of Keratoplasties 99 Chapter 7 The Complications After Keratoplasty 101 Patricia Durán Ospina VI Contents Chapter 8 Diagnosis and Treatment of a Rare Complication After Penetrating Keratoplasty: Retained Descemet’s Membrane 119 Roberto Ceccuzzi, Gabriella Ricciardelli, Annita Fiorentino, Meri Tasellari, Giovanni Furiosi and Paolo Emilio Bianchi Chapter 9 Topical Bevacizumab Therapy in Graft Rejection After Penetrating Keratoplasty 127 Sandeep Saxena and Neha Sinha Preface The practice of this subspecialty in ophthalmology diversifies each day, and grows with new surgical techniques and therapeutic approaches to corneal pathologies. This book on keratoplasties, divided into three sections, may perhaps seem too undemanding to some, but all the new therapeutic and surgical techniques are well approached in these chapters. The long-lasting penetrating keratoplasty (PK) technique has shown to have good results, both anatomical and optical, leading to better visual outcomes despite other keratoplasty techniques, maintaining its place in corneal transplant surgery until today, especially in cases of infectious disease of the cornea. Moreover, for a long time, PK relegated lamellar keratoplasty (LK) techniques to primarily tectonic indications due to poor visual results. The development of new technologies (diamond knives, microkeratomes, lasers) and the creation of new surgical techniques (descemeting and predescemeting techniques) leading to better interfaces, have given a new impulse to lamellar keratoplasty surgery in the last years. Deep anterior lamellar keratoplasty (DALK) and the Descemet stripping endothelial keratoplasty (DSEK), less invasive and equally effective both in anatomical and visual outcomes, are the leading techniques for most corneal pathologies in preference to the PK today. This edition is in an electronic format, allowing universal access to everybody regardless of the time of day or setting, portability, and speed of information access. Such features help to reduce the time needed for research, showing more feasibility for all readers. The main purpose of this book is to show the different therapeutic and surgical techniques to treat corneal pathologies, as well as analyzing the postoperative complications of the different treatments. I hope that this book can serve as a good tool to all students approaching the field of corneal transplantation, and to all practitioners working in the field of corneal transplantation as a contribution to improvement in care for patients with corneal disease. Luigi Mosca, MD Catholic University “Sacro Cuore”, Rome, Italy