**1. Introduction**

126 Keratoplasties – Surgical Techniques and Complications

Doing so allows the surgeon to visually inspect the tissue for missing fragments, which could be removed from the anterior chamber. Despite this precaution, it would be difficult, if not impossible, for the surgeon to discern whether a small lamellar remnant was retained

Retention of the host's Descemet's membrane is a complication which can occur during the course of a penetrating keratoplasty and which eventually leads to loss of graft clarity by clouding or by coming into contact with the graft endothelium. The retained Descemet's membrane can compromise endothelial tissue by contact injury or by limiting diffusion of aqueous humour nutrients. That's why the use of YAG laser could allow not only the optic zone relief but also the diffusion of aqueous humour nutrients, avoiding complications related to retransplantation. Moreover this "non open sky" technique grants us smaller risk of postoperative complications but avoids only a little central hole which results inadequate in case of big descemetical residue. We have also to notice that Yag laser could induce a

Archila E.A., Ramirez Cabrera M.F. Alviar A.M., Double Descemt's Membrane in

Banik R, Novick LH, Smith RE, & Chuck RS. Retrocorneal Membrane With Descemet's

Bui K.M., Tu E.Y. *A R*igid Band of Retained Descemet's Membrane as a Mechanical Cause of Graft Non-attachment in Repeat DSAEK. ARVO 2011 Abstract - May 1-5 2011 Chen YP, Lai PCC, Chen PYF, Lin KK, & Hsiao CH. Retained Descemet's membrane after

Cohen AV, Goins KM, Sutphin JE, Wandling GR, & Wagoner MD. Penetrating keratoplasty

Ichihashi Y., Nejima R., Matsumoto Y., Kawakita T., Miyata K., Tsubota K., Shimmura S.

Ide T., Yoo S.H., Kymionis G.D., Shah P. A., & O'Brien T. P.. Double Descemet's Membranes

Romaniv N., Price M.O., Price F. W., & Nick Mamalis. Donor Descemet's Membrane Detachment After Endothelial Keratoplasty *Cornea* 2006; 25, 8: 943-947 Sbarbaro JA, Eagle RC, Thumma P, & Raber IM. Histopathology of Posterior Lamellar

Endothelial Keratoplasty Graft Failure *Cornea* 2008;27:900–904

Tomography *Ophthalmic surgery laser and imaging* 2008; 39, 05: 422-425 Mittal V, Mittal R, & Sangwan VS. Successful Descemet's stripping endothelial keratoplasty in congenital hereditary endothelial dystrophy *Cornea* 2011 Mar;30(3):354-356 Mondloch M. C., Giegengack M., Terry M. A. & Wilson D. J. Histologic Evidence of

versus deep anterior lamellar keratoplasty for the treatment of keratoconus. *Int* 

Results of Non-Descemet's Stripping And Automated Endothelial Keratoplasty

After Penetrating Keratoplasty With Anterior Segment Optical Coherence

Retained Fetal Layer of the Descemet's Membrane After Presumed Total Removal for Endothelial Keratoplasty A Possible Cause for Graft Failure *Cornea* 2007; 26, 10:

Penetrating Keratoplasty *J Refract and Corneal Surg. 9 65-66, 1993*

penetrating keratoplasty *J Cataract Refract* Surg 2003; 29:1842–1844

further Descemet's – endothelial failure thanks to its thermic effect.

Detachment *Cornea* 20(7): 763–764, 2001

(nDSAEK) ARVO 2011 Abstract - May 1-5 2011

*Ophthalmol* (2010) 30:675–681

1263-1266

on the recipient's posterior cornea.

**6. References** 

Neovascularization is defined as formation of new vessels from vascular endothelial cells derived from existing blood vessels. These new immature vessels are friable. They have increased permeability, lack structural integrity, and can result in lipid deposition and corneal opacities. Ultrastructurally, corneal neovascularization is characterized by vessels encroaching through separated stromal lamellae. Corneal vascularization following penetrating keratoplasty may result in graft rejection.
