الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The aim of the work: to review current concepts about Posterior Lamellar Keratoplasty,techniques results,complications,and its management.
Conclusion :
Posterior Lamellar Keratoplasty means replacement of diseased posterior layers of the cornea (posterior stroma,Descemet’s Membrane,and Endothelium)with similar disc of donor cornea. It is done with two techniques: The first technique in which a corneal flap is made using a microkeratome and retracted then trephination and excision of posterior diseased layers of the cornea and then transplantation of healthy donor corneal button and secured in its place with sutures and then the flap is repositioned .The second technique in which a corneal stromal pocket is formed through a limbal or scleral incision. posterior stromal disc with the diseased endothelium is excised using an intrastromal trephine and healthy donor posterior stroma and endothelium is placed endothelial side down on a viscoelastic covered spatula for insertion into the recipient eye through the limbal /scleral incision.
Posterior Lamellar Keratoplasty avoids many of the disadvantages of full-thickness Penetrating Keratoplasty, such as high refractive errors, irregular astigmatism, anisometropia, corneal suture problems, the dangerous open-sky surgical approach, and the risk of post-operative wound dehiscence. Unfortunately, manual posterior lamellar dissection is technically very difficult, time-consuming, and imprecise .
Several techniques have been developed to facilitate the lamellar dissection and to improve the smoothness of the lamellar interface from which the use of the femtosecond LASER that can be programmed to produce bladeless corneal lamellar cuts at any depth with accompanying trephination cuts of desired diameters. This laser may also be used for donor tissue cutting in Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK), significantly reducing its technical difficulty and improving the cut precision .