Femtosecond Laser-assisted Allogenic Additive Stromal Keratoplasty With or Without Excimer Laser Donor Keratomileusis for Management of Keratoconus.

Mohammad-Reza Jafarinasab,Yasaman Hadi,Goldis Espandar

doi:10.18502/jovr.v16i4.9761

Abstract

We describe a modified allogenic intrastromal lenticule implantation technique for management of keratoconus (KCN). Patients with advanced KCN already scheduled for corneal transplantation were enrolled. An allogenic corneal lenticule was implanted inside a stromal pocket created by femtosecond laser. In three cases, the estimated refractive error of the recipient eyes was corrected on the donor lenticules using an Excimer laser. All operated eyes underwent corneal crosslinking at the time of surgery. This method was named “Femtosecond Laser-assisted Allogenic Stromal Keratoplasty Without and With Excimer Laser-assisted Donor Keratomileusis”; briefly called FASK and FASK Plus EDK, respectively. Two out of five patients were satisfied with the results. There was a decrease in the average simulated keratometric values as well as myopia when FASK Plus EDK was performed. Increased corneal thickness was achieved in all cases. Graft edema gradually decreased over weeks but interface wrinkling and lenticule folds in the visual axis remained as a problem during follow-up period. No other complications were encountered.

Highlights

IntroductionFASK for Corneal Ectasia; Jafarinasab et al Depending on the diagnostic criteria and different diagnostic tools employed, estimation of the incidence and prevalence of KCN in any given population is different.[3–5]
The concept of tissue addition for correction of refractive errors was first introduced by Jose Barraquer in 1949.[16]. With the development of laser vision correction and synthetic intrastromal inlays, the Barraquer technique of epikeratophakia and keratomileusis were substituted by newer techniques, concerns were raised regarding diffusion of nutrients across the synthetic inlay.[13]
Lenticules extracted from eyes undergoing SMILE have been used as autograft or allografts for correction of hyperopia based on Barraquer‘s law of thickness.[17–20]

Summary

Introduction

FASK for Corneal Ectasia; Jafarinasab et al Depending on the diagnostic criteria and different diagnostic tools employed, estimation of the incidence and prevalence of KCN in any given population is different.[3–5]

Methods

Results

Conclusion