Purchase this article with an account.
Joaquim N. Murta, Andreia Rosa, Maria Quadrado, Sérgio Brito, Ana Cardoso; Femtosecond Laser and Microkeratome Preparation of Ultrathin (UT) DSAEK Grafts. The first clinical results. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3136.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the use of a femtosecond laser and a mechanical microkeratome to prepare ultrathin posterior corneal disks for Descemet stripping automated endothelial keratoplasty (DSAEK) and to assess associated visual results, disk thickness and endothelial cell loss.
This clinical study involved ultrathin DSAEK tissue preparation used in 13 patients with endothelial dysfunction.The first cut was performed with an Intralase FS60 laser and the second cut with a Moria CBm 300- microkeratome. The thickness of the first cut was modified for each cornea to obtain a final graft thickness of 120 µm. Post-op central graft thickness was performed with corneal laser tomography (Spectralis). Central endothelial cell density (ECD) was calculated before and 3 months after surgery.
Final graft thickness was 88.3+27.6 µm, 77.2+26.6 µm and 74.3+27.5 µm at one week, one and three months post-op, respectively. No loss of corneas due to irregular cuts or perforation during preparation. The mean BSCVA was 0.41, 0.52, and 0.72(0.39, 0.28 and 0.14 LogMAR) after one week, one and three months post-op, respectively. Precut and post-op (3 months) ECDs averaged 2553 cells/mm2 and 1882 cells/mm2, respectively, representing 26.3% endothelial cell loss after 3 months of the surgery.
Femtosecond laser and microkeratome can be used sequentially to prepare custom ultrathin DSAEK grafts with no loss of corneas. This procedure minimizes the variability inherent to microkeratomes and allows very quick recovery of visual acuity after posterior lamellar keratoplasty
This PDF is available to Subscribers Only