We were joined by Dr. Uri Soiberman of the Johns Hopkins Wilmer Eye Institute for our November 2022 webinar. Dr. Soiberman offered his expertise on manual techniques for deep anterior lamellar keratoplasty (DALK) surgery in patients with keratoconus. This included his latest experience with the groove and peel technique which was recently published in Cornea.
The webinar begins with a discussion of keratoconus disease incidence, etiology and the impact on patients, as well as a brief overview of the current treatments and some of their limitations. Dr. Soiberman reviews some of the general advantages of DALK over conventional penetrating keratoplasty (PKP) along with some literature on the topic. He discusses some of the current techniques for performing DALK, including one of the most common—the “big bubble” technique—which was described by Anwar and Teichman in 2002. Highlighting some of the challenges and limitations of this technique, he introduces various other techniques described over the years for manual, or non-big bubble, DALK.
Dr. Soiberman dives into a series of cases using techniques including big bubble, manual dissection, the Melles technique, and finally several cases of the groove and peel technique. This leads to a detailed discussion of the groove and peel technique, including approach, instrumentation, surgical pearls and principles behind it. The webinar concludes with a lively Q&A discussion.
Key takeaways include:
- Overview of keratoconus & current treatments
- Advantages of DALK over PK
- Problems with big bubble DALK
- Various techniques for performing DALK
- Case: Big bubble DALK
- Case: Manual dissection to rescue failed big bubble
- Case: Melles technique for DALK
- Three cases: Groove & peel technique for DALK
- Overview of groove & peel DALK technique
- Groove & peel DALK pearls
- Conclusions
Eversight's free webinars are a great way for you to connect, learn and train digitally with leading ophthalmologists and researchers from around the world. We invite you to RSVP for scheduled webinars and browse our recording library.
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About the author
Michael Szkarlat
Partner Development Director
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Michael has been with Eversight since 2016 and has recently worked to develop Eversight's educational wet lab programs for EK surgery and a standardized protocol for DALK practice in a wet lab setting. His eye banking experience is rooted in the preparation of corneal grafts and spent nearly five years as Eversight’s Medical Director designee in charge of training clinical team members to prepare corneal tissue for DMEK and DSAEK surgery. In his time at Eversight, Michael has presented at scientific conferences, been involved in clinical research and developed innovations in tissue processing. He was named an IAPB Eye Heath Hero in the innovations category. Michael is passionate about community-based eye banking and honoring the precious gift that is donation. When not at work, he enjoys traveling with his wife and baking artisan sourdough bread.