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Oana M. Dumitrascu, Xiaohui Li, Yaron Rabinowitz; Penetrating Keratoplasty using a Femtosecond Laser versus the Mechanical Trephine in Patients with Keratoconus. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3375.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the visual outcomes of two different keratoplasty techniques in patients with keratoconus
This study represents a retrospective comparative surgical case series, including 126 keratoconus patients (137 eyes) who had penetrating keratoplasty at Cornea Genetic Eye Institute, Beverly Hills, California. 56 keratoconus patients (66 eyes) underwent Femtosecond enabled keratoplasty (FLEK). Their visual parameters were compared with those of 60 patients (71 eyes) who had traditional blade trephination penetrating keratoplasty (PKP). The range of follow-up was between 3 and 12 months.Main outcome measures were: uncorrected (UCVA) and best-spectacle corrected visual acuity (BSCVA), manifest refractive spherical equivalent and topographically determined astigmatism.
BSCVA was significantly better as early as 3 months (P= 0.001), and even at 12 months of follow-up (p=0.007) in the FLEK group. Visual recovery to the driver’s license vision after 3 months was significantly better in the FLEK group (p<0.001). Topographic astigmatism was better in the FLEK group, but the difference between the two groups reached significance only at 3 months of follow-up (p=0.001). Postoperative complications noted were not different between the 2 groups.
Faster visual recovery and better long-term outcomes were observed in keratoconus patients that had FLEK compared to those that had the mechanical PKP procedure. At 12 months after all sutures had been removed in both groups, the topographic astigmatism in the FLEK was less but not statistically significantly different from the mechanical PKP group.
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