Instrumentation and Technical Considerations in Doughnut Refractive Lenticule Transplantation

The evolution of DRLT as a novel surgical approach for advanced keratoconus has brought forward the need for a precise, reproducible, and anatomically respectful technique. Unlike full-thickness grafting procedures, DRLT achieves structural and functional corneal rehabilitation through the implantation of a negative meniscus-shaped doughnut stromal lenticule into a mid-stromal pocket preserving the native endothelium and optical axis [1, 2].