Anterior lamellar keratoplasty (ALK) has always been an attractive option for treating anterior corneal pathology, such as scars following trauma or infectious keratitis, and superficial corneal dystrophies. Removing only an anterior corneal lamella with retention of posterior corneal tissue allows for a stronger eye postoperatively, earlier suture removal and a considerably lower risk of graft rejection.
However, the procedure has had limited use because of poor visual outcomes due to the irregularity of the interface between the host and donor tissue which occurs with manual corneal dissection. It has also been difficult to get a good match between the architecture of the residual host corneal stroma and the donor corneal tissue using manual techniques.
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