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PAOLO BORDIN, Gabriele Vizzari; Intra Stromal Keratoplasty (ISK): a new femtolaser technique in patient with keratoconus. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1571.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study is to describe the efficacy and safety of a new technique for performing deep lamellar keratoplasty using femtosecond laser in the surgery of keratoconus: Intra Stromal Keratoplasty (ISK)
13 eyes presented with keratoconus were referred for progressive corneal ectasia and worsening visual acuity. Their corneal central thickness was 384±71 µm. They underwent femtolaser-assisted (Victus, B&L) deep anterior lamellar keratoplasty (DALK). The femtosecond laser with real-time OCT was used to create a vertical side cut on donor of 268±69 µm with an anterior diameter of 8 mm and a posterior diameter of 8.1 mm in order to create a small step in the external profile. In the recipient cornea was created a corneal pocket using femtosecond laser with a diameter of 9 mm at 221 µm from the corneal vertex. Two corneal incisions of 2.5 mm at 40° and 220° were created in the recipient cornea, followed by a manual dissection of the stromal pocket to allow the insertion of the donor stromal strip. Two Nylon 10-0 stitches were positioned on the corneal incisions.
The patients were followed up on day 1, day 5, at 2 weeks, 4 weeks and 8 weeks. At each follow-up visit, complete ocular examination and corneal topography were performed. Best corrected visual acuity(BCVA) was measured using a Snellen table. At 8 weeks the cornea was clear and the stromal strip in the right position. The mean BCVA improved significantly after surgery changing from 0.21±0.13 to 0.45±0.15. The mean preoperative keratometric cylinder decreased from 7.78±1.6 D to 5.19±1.4 D postoperative. No complications were encountered.
ISK allows to perform a more safety surgical technique in keratoconus. It allow a fast recovery of the visual acuity without corneal suturing complications.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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