Optical lamellar keratoplasty using the barraquer microkeratome.

The Barraquer microkeratome may be used to cut donor and host lenticules for lamellar keratoplasty. Eleven eyes of nine patients with visually symptomatic anterior corneal opacification underwent optical lamellar keratoplasty using this technique. In three eyes, this was combined with extracapsular cataract extraction and posterior chamber intraocular lens implantation. Preoperatively, four patients had anterior stromal scars in the visual axis. There were three patients with Reis-Bückler, and two with granular corneal dystrophy. Postoperatively, visual acuity improved in ten eyes and was unchanged in one. We conclude that the Barraquer microkeratome facilitates lamellar keratoplasty and may be successfully combined with extracapsular cataract extraction and posterior chamber intraocular lens implantation. Optical lamellar keratoplasty may be an alternative to penetrating keratoplasty in selected patients with localized anterior corneal opacification.