Onlay Lamellar Keratoplasty

An onlay lamellar tissue was sutured into a prepared annular keratectomy over a de-epithelialized surface of corneal thinning secondary to corneal melt.
  • A type of lamellar keratoplasty that is used to reinforce thinned or ectatic corneas
  • Unlike inlay lamellar keratoplasty, there will be no anterior stromal tissue removed from the recipient cornea
  • Advantages:
    • Less invasive than penetrating keratoplasty
    • No risk of rejection
    • Can be removed when penetrating keratoplasty is to be done
  • Complications include:
    • Insignificant peripheral opacities
    • Epithelial ingrowth
    • Neovascularization of the graft-recipient interface that may requires graft replacement
    • Recurrent erosions
    • Persistent epithelial defect
    • Graft melt