Sutureless lamellar keratoplasty - A modified approach for fibrin glue application

Purpose: To report a case where fibrin glue was applied with a modified approach to secure the graft to the host bed in lamellar keratoplasty. Methods: One patient with epithelial membrane dystrophy, Salzmann nodular degeneration, and amyloid deposits in the cornea underwent lamellar keratoplasty by using fibrin glue. The glue components were applied separately: the fibrin component on the stromal bed and thrombin component on the stromal side of the lamellar graft. Tissue adhesion, corneal condition, and visual acuity were evaluated postoperatively. Results: Best-corrected visual acuity 4 months after surgery was 20/30. The graft remained clear and well positioned 9 months after surgery. Conclusions: We report a case of visual acuity improvement and efficient adhesion of the lamellar graft after lamellar keratoplasty by using fibrin adhesive. The components of the glue can be applied separately, allowing more time to position the graft on the stromal bed.