Lamellar Keratoplasty for Advanced Keratoconus

Ectatic corneal diseases are a group of disorders resulting in progressive corneal steepening and thinning. Keratoconus, keratoglobus, pellucid marginal degeneration, post-keratorefractive ectasia, and corneal graft ectasia are the types of corneal ectasia. Early diagnosis with appropriate diagnostic tools can help prevent progression, eliminating the need for corneal transplantation. Lamellar or full thickness corneal transplantation are the treatment options for advanced diseases. Although the visual outcomes of penetrating keratoplasty are comparable to anterior lamellar keratoplasty (ALK) especially in keratoconus, ALK is the preferred treatment of choice considering benefits including reduced graft rejection, less long-term complications, and better graft survival. This article reviews the various surgical techniques in ALK with its clinical outcomes in advanced keratoconus.