Lamellolamellar sclerokeratoplasty. Where do we stand today?

Purpose To determine the efficacy of lamellar sclerokeratoplasty for patients with extensive cornea/corneoscleral lesions. Methods One hundred and sixty-six eyes with extensive corneal/corneoscleral lesions of different aetiology who were poor candidates for conventional lamellar keratoplasty/penetrating keratoplasty were selected for lamellar sclerokeratoplasty. Results Corneal clarity of 3+ or more was achieved in 62 eyes by a single procedure. In the remaining 104 eyes graft clarity was < 2+ due to post-surgical complications (n = 56) or remaining recipient deep opacity (n = 48). Conclusions Astigmatism, the bugbear of final visual achievement despite a clear graft, was not a frequent problem following lamellar sclerokeratoplasty. Similarly, a gain in visual acuity to 6/18 or more in 30% of eyes, cosmetic improvement in the majority of cases and prevention of recurrence of the original disease process in susceptible cases all point towards the safety and effectiveness of the procedure. Thus, lamellar sclerokeratoplasty should be considered as a management option for patients with extensive corneal/corneoscleral lesions.