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In lamellar keratoplasty, the front part of the patient's cornea (comprising the epithelium, Bowman's membrane, and most but not all of the stroma) is removed and replaced with a donor "button" of corneal tissue.
Lamellar keratoplasty is not as invasive as a penetrating keratoplasty (full thickness transplant) and may be the preferred option for patients whose cornea is not completely compromised.
Techniques for performing lameller keratoplasty are evolving. The quality of the outcome depends in part on the quality of the cutting process - both for removal of the patient's tissue and cutting of the donor button. This process is done with microkeratomes (the devices also used to cut the LASIK flap). The emergence of ophthalmic femtosecond lasers seems to be an important advance in lamellar keratoplasty.
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