Purpose
To describe and assess the use of a new anvil-like trephination pattern in penetrating keratoplasty (PK) assisted by femtosecond laser.
Methods
30 eyes underwent anvil PK. An Intralase Femtosecond Laser 150 KHz (iFS150TM, Abbott Medical Optics -AMO, Santa Ana, CA, USA) was used to create anvil shaped penetrating cuts on both donor and recipient corneas. Diode laser welding procedure was performed in order to improve the healing process. All patients were evaluated for corrected distance visual acuity, pachimetry, topography and endothelial cell density.
Results
All surgery were successful and without any intraoperative complications. This profile enables a safe and easy to perform suturing procedure, with an immediate closure effect evidenced during surgery. The large interface between donor and recipient tissue supports the laser welding procedure. A 6 months follow up study showed that the anvil shaped flap provides a better visual acuity recovery and a reduction in the number of rejection. Mean post-operative BSCVA (logMAR, mean ± SD) was 0.50 ± 0.24 at 1 month, 0.32±0.19 at 3 months, 0.19±0.14 at 6 months. Mean pachimetry was 537 ± 56 µm at 1 month, 550±77 µm at 3 months and 528±70 µm at 6 months. Mean preoperatory endothelial cell density was 2300, while postoperative results are 1945±363 at 1 month, 1881±401 at 3 months and 1781±393 at 6 months.
Conclusions
Use of anvil trephination profile was effective and safe to perform PK. Short term visual results and refractive results are encouraging compared with those of conventional PK studies. Longer term follow-up and comparative studies are necessary to determine precisely advantages of this technique.
Keywords: 578 laser •
479 cornea: clinical science •
502 dopamine