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Ijeoma Asota, Matthew Wade, John Xie, Sumit Garg, Roger Steinert, Marjan Farid; Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty with Zig-zag Configuration: Initial Outcomes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1751.
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© ARVO (1962-2015); The Authors (2016-present)
To report the early refractive results and clinical outcomes of deep anterior lamellar keratoplasty (DALK) performed using the femtosecond laser with the zig-zag incision configuration.
30 consecutive eyes underwent femtosecond laser assisted DALK with zig-zag configuration. Clinical records were reviewed retrospectively. Corrected distance visual acuity (CDVA), manifest and topographic astigmatism, and complications were reviewed.
In 26 eyes, a big-bubble was successfully achieved. The remaining 4 eyes required dissection down to a very thin residual stromal bed. Postoperative follow-up ranged from 3 months (n=28) to 2.5 years (n=3). At post-operative month 3, mean CDVA was 20/30 (range 20/20-20/60), mean manifest astigmatism was 3.5 D (range 1.25-6 D), and mean topographic astigmatism was 4.23 D (range 1.1-9.25 D). These outcomes remained stable throughout the follow up period. Complications included suture revision at post-operative month 3 for wound gape in one patient, and an episode of stromal rejection in one patient.
Visual outcomes of femtosecond laser-assisted zig-zag DALK are similar to our results with zig-zag full thickness penetrating keratoplasty. In addition, this technique offers a decreased risk of endothelial rejection in healthy eyes compared to penetrating keratoplasty.
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