Results Of Femtosecond-assisted Anterior Lamellar Keratoplasty In Keratoconus

Abstract

 

Purpose:

 

To describe the outcome of femtosecond-assisted anterior lamellarkeratoplasty (FALK) in patients with advanced keratoconus

 

Methods:

 

Anterior lamellar keratoplasty was performed in 11 eyes withkeratoconus using 1 MHz LDV (Ziemer) femtosecond laser to cutboth donor and recipient cornea. The lamellar cut was plannedto leave at least 50 microns of recipient stroma. Donor corneaswere cut using Ziemer’s artificial anterior chamber onsite. 10-0 nylon interrupted sutures were place in all patients.Follow-up visits were scheduled at 1 week, 1, 3 & 6 months

 

Results:

 

Mean uncorrected visual acuity previous to surgery was 1.35LogMAR. At 1 month postoperatively it was 1.05 LogMAR, 0.99LogMAR at 3 months and 0.96 at 6 months. The difference betweenpre and postoperative UCVA was statistically significant (p0.05).Sixpatients (54%) had interface opacity, 5 patients (45%) had striae,1 patient (9%) was converted to penetrating keratoplasty dueto perforation, 1 patient needed regrafting because of wounddehiscence and keratitis, and 1 patient had ocular hypertension.There was one case of stromal rejection 6 months after the graft

 

Conclusions:

 

Femtosecond laser-assisted anterior lamellar keratoplasty doesnot provide a smooth enough surface to avoid interface opacity.This technique is not free of complications such as perforation,ocular hypertension, even rejection. Visual results could besuboptimal compared with penetrating keratoplasty (PK), neverthelessFALK complications could be less severe than PK complications.  

 

 

Keywords: cornea: clinical science • keratoconus • laser