Abstract
Purpose: :
Most current femtosecond laser-assisted keratoplasty wound shapes have either the anterior or the posterior diameter larger than the other. In the case of a larger anterior diameter, there can be a higher risk of graft vascularization, and in the case of a larger posterior diameter, there can be a higher risk of angle closure and subsequent glaucoma. The purpose of this study was to investigate the wound leakage pressure of 2 novel pattern designs for femtosecond laser-assisted keratoplasty, each of which allows for the creation of a cut with the same anterior and posterior wound diameters.
Methods: :
Full-thickness cuts were made in 14 corneoscleral rims with the femtosecond laser using 2 novel pattern designs and 1 established design. Both novel patterns, the "bolt" (n=5) and the "dove-tail" (n=4), were designed to have 8 mm anterior and posterior wound diameters. The established pattern, the "top-hat" (n=5), was cut with 7 mm anterior and 9 mm posterior wound diameters. In addition, 8 mm vertical cuts were created in 5 other corneoscleral rims. All buttons were replaced and sutured with 16 interrupted 10-0 nylon sutures, and the wound leakage pressures were measured using a digital manometer.
Results: :
The average wound leakage pressure of the "bolt" was 84.6 mmHg; of the "dove-tail" was 106.5 mmHg; of the "top-hat" was 92.4 mmHg; and of the vertical cut was 38.2 mmHg. There was a statistically significant difference between all of the shaped cuts compared to the vertical cut (p<0.001), but there was no difference between the "top-hat" and the novel shapes (p=0.15).
Conclusions: :
Both novel patterns demonstrated similar resistance to wound leakage compared to the established design, and they offer the advantage of having the same size anterior and posterior wound diameters.
Keywords: cornea: clinical science