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R. F. Steinert, M. Farid, M. Kim; Results of Zig-Zag Femtosecond Laser Incision for Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4706.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the technique and results of a zig-zag shaped femtosecond laser penetrating keratoplasty (PKP) incision, with the objective of obtaining better visual recovery (quality and speed of recovery) and stronger wound healing.
The IntraLase femtosecond laser, with modified hardware and software for IntraLase Enhanced Keratoplasty (IEK), was used to perform zig-zag shaped (0.5 mm lamellar ring at 320 micron depth, connected by 45 degree angles side-cuts to the anterior and posterior surfaces) incisions on patients undergoing full-thickness PKP.
As of November 2006, 16 eyes had reached between 1 and 9 months follow-up. Orbscan topography was obtainable as early as postoperative day 1 on 7 eyes because of the high degree of immediate corneal surface regularity. For 8 eyes with topography at 3 months, the mean simK was 3.5D. 6 of 8 eyes were at or below the mean, with a range of 0.4 to 8.4D prior to any suture adjustment. Macular disease in most patients precluded meaningful visual acuity data pending enrollment of further patients. One patient with rapid suture loosening and subsequent suture breakage had full suture removal by 3 months, with 2.3 D of regular astigmatism and no evidence of wound dehiscence.
This initial short-term series indicates that femtosecond laser PKP incisions are technically feasible and may improve the speed of recovery and overall quality of optical results. The zig-zag configuration is biomechanically stable and secure. A study with a larger series and a control group is in progress.
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