LAMELLAR

KERATOPLASTY

Another important application of the CPC and the PocketMaker Ultrakeratome technology is the use of corneal pockets as a starting point for lamellar anterior and endothelial keratoplasty.

The patented PocketMaker Lamellar Keratoplasty System (PMLKP) is a revolutionary development which uses

  1. the superior PocketMaker Ultrakeratome cutting technology,
  2. a most precise stop-delimited trephination technology for the host cornea in order to limit the trephination at the pocket level and
  3. a PocketMaker Ultrakeratome artificial anterior chamber (PMAAC) in order to apply the superior cutting technology of the PocketMaker Ultrakeratome to the donor corneal button.

Advanced lamellar keratoplasty

The following video shows the huge treatment potential of the PocketMaker Ultrakeratome even in heavily destroyed eyes. The eye is almost blind (light perception) from alkali burn. With the help of the PocketMaker lamellar keratoplasty unit consisting of the PocketMaker and the trephination delimiter, it was possible to treat that eye successfully and to achieve an excellent uncorrected vision of 0.15 next day! The creation of the corneal pocket itself by means of the PocketMaker was performed without using the surgical microscope and is therefore only partially shown on the video. What one can see at the end of the video is the unique PocketMaker trephination system and the "implantation" of the artificial cornea.

 The fact, that the technology allows to safely cut large pockets with perfect smooth interfaces as close as 50 microns to the Endothelium will change Lamellar Keratoplasty to a very safe, effective and easy to perform procedure with a very low conversion rate. Since the PocketMaker technology allows the surgeon to perform a corneal cut of any shape it is also possible to cut even parallel to the posterior corneal surface – an important feature to avoid peripheral transplant steps in Endothelial Keratoplasty.

A main problem when creating corneal pockets with Femtosecondlaser technology as a starting point for CISIS, keratoplasty or keratoprothesis is that the corneal tissue is usually scary or turbid or may have folds at least in a limited area. In such cases incomplete Femtosecondlaser pockets are not rare. The PocketMaker technology, however, is not sensitive to such limitations and incomplete cutted pockets are usually not seen since scars, turbidity or folds do not affect the safety and effectiveness of the PocketMaker Ultrakeratome cutting process. A further problem in this kind of applications when using the Femtosecondlaser technology is the fact, that the localized tissue rupture of the laser shots during tissue cutting have often to be applied deep in the corneal stroma. However, the deeper the Femtosecondlaser application the more imprecise is the cutting and the more uncertain the result. In contrast, the precision and quality of cutting of the PocketMaker Ultrakeratome technology is independent of the cutting depth. Moreover, the Pocket-Maker is so precise that it can cut safely at least 50 microns close to the Endothelium with a most perfect cutting interface.