Femtosecond laser-assisted deep anterior lamellar keratoplasty for keratoconus and keratectasia

• Main Authors: Yan Lu, Yu-Hua Shi, Li-Ping Yang, Yi-Rui Ge, Xiang-Fei Chen, Yan Wu, Zhen-Ping Huang
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2014-08-01
• Series: International Journal of Ophthalmology
• Subjects: femtosecond laser; deep anterior lamellar keratoplasty; keratoconus; post-LASIK keratectasia
• Online Access: http://www.ijo.cn/en_publish/2014/4/20140409.pdf
• ISSN: 2222-3959; 2227-4898

<b>AIM:</b> To describe the initial outcomes and safety of femtosecond laser-assisted deep anterior lamellar keratoplasty (DALK) for keratoconus and post-LASIKkeratectasia.<b>METHODS</b>:In this non-comparative case series, 10 eyes of 9 patients underwent DALK procedures with a femtosecond laser (Carl Zeiss Meditec AG, Jena, Germany). Of the 9 patients, 7 had keratoconus and 2 had post-LASIK keratectasia. A 500 kHz VisuMax femtosecond laser was used to perform corneal cuts on both donor and recipient corneas.The outcome measures were the uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), corneal thickness, astigmatism, endothelial density count (EDC), and corneal power.<b>RESULTS:</b> All eyes were successfully treated. Early postoperative evaluation showed a clear graft in all cases. Intraoperative complications included one case of a small Descemet’s membrane perforation. Postoperatively, there was one case of stromal rejection, one of loosened sutures, and one of wound dehiscence. A normal corneal pattern topography and transparency were restored, UCVA and BCVA improved significantly, and astigmatism improved slightly. There was no statistically significant decrease in EDC.<b>CONCLUSION:</b> Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty could improve UCVA and BCVA in patients with anterior corneal pathology. This approach shows promise as a safe and effective surgical choice in the treatment of keratoconus and post-LASIK keratectasia.