Purpose: To describe a new technique of lamellar surgery and to compare the results of 150 cases treated with this technique with those observed in as many cases of penetrating keratoplasty (PK). Patients and Methods: One hundred and fifty deep lamellar keratoplasty (DLKP) procedures were performed in patients affected by various diseases of the corneal stroma but having a preserved endothelium. Each case was matched with a patient of similar age, gender and pathology who had undergone PK. The following parameters were evaluated: number of rejection episodes, density of endothelial cells, degree of ophthalmometric astigmatism, visual acuity and ocular tension. Statistical analysis was performed with Student’s t test to compare patients in a similar clinical setting. Results: No rejection episodes were recorded in the 150 patients who underwent DLKP surgery, whereas rejections occurred in 4% of the patients after PK. A statistically significant higher density of endothelial cells was found in DLKP cases, who also experienced a lower degree of astigmatism than PK patients. A slight but significant improvement in visual acuity was achieved in DLKP patients. Conclusion: Our results confirm that DLKP is the preferential procedure when no endothelial damage is involved.

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