September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Double Docking Technique for Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty
Author Affiliations & Notes
  • Eric Gabison
    Cornea, Cataract & Refractive Surgery, Fondation Rothschild, Hôpital Bichat, Paris, France
  • Damien Guindolet
    Junior Resident, Rothschild Foundation, APHP Bichat Hospital, Paris, France
  • Diem Trang Nguyen
    Junior Resident, Rothschild Foundation, APHP Bichat Hospital, Paris, France
  • Serge Doan
    Cornea, Cataract & Refractive Surgery, Fondation Rothschild, Hôpital Bichat, Paris, France
  • Isabelle Cochereau
    Cornea, Cataract & Refractive Surgery, Fondation Rothschild, Hôpital Bichat, Paris, France
  • Footnotes
    Commercial Relationships   Eric Gabison, None; Damien Guindolet, None; Diem Trang Nguyen, None; Serge Doan, None; Isabelle Cochereau, None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Eric Gabison, Damien Guindolet, Diem Trang Nguyen, Serge Doan, Isabelle Cochereau; Double Docking Technique for Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Deep anterior lamellar keratoplasty (DALK) is a treatment of choice for lamellar keratoplasties for Keratoconus. We describe a new technique including a double docking procedure for femtosecond laser assisted DALK surgeries.

Methods : For ex-vivo experiments, corneal buttons were mounted on an artificial anterior chamber and lamellar cuts were performed using the Victus femtosecond Laser (Bausch & Lomb). The air dissection technique according to Anwar permitted the achievement of a "big-bubble" separating the Descemet membrane from the residual posterior stroma. A second docking was then performed and a penetrating cylindrical vertical cut was achieved on the posterior stroma permitting the manual removal of the “big-bubble” stromal roof.
The victus laser was subsequently used for lamellar keratoplasties for advanced keratoconus and deep corneal opacities.

Results : Lamellar cuts were performed using the Victus femtosecond Laser on corneal buttons mounted on an artificial anterior chamber. Real-time OCT visualization allowed the direct control of non-penetrating cuts. The air dissection technique according to Anwar permitted the achievement of a "big-bubble" separating the Descemet membrane from the residual posterior stroma. A second docking was then performed and a penetrating cylindrical vertical cut was achieved on the posterior stroma permitting the manual removal of the “big-bubble” stromal roof. The victus laser was subsequently used for lamellar keratoplasties for advanced keratoconus and deep corneal opacities. The curved applanation limited folds formation on the posterior stroma even in particularly advanced keratoconus associated corneal thinning. The double docking technique was reproducible and safe using the Victus laser as the procedures were performed under direct visualization of the corneal tissue during both the calibration and the achievement of the cuts.

Conclusions : Femtosecond assisted DALK surgery has been shown to be safe and efficient both ex-vivo and in vivo. The double docking DALK procedure needs to be further evaluated for the surgical management of corneal thinning and/or opacities.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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