Femtosecond Laser–Assisted Superficial Lamellar Keratectomy for the Treatment of Superficial Corneal Leukomas

Abstract

To determine if superficial lamellar corneal excision with femtosecond laser followed by phototherapeutic keratectomy (PTK) using a masking substance improves visual acuity and optical quality of patients with severe corneal opacities. Twelve eyes with corneal haze or scarring underwent confocal microscopy to estimate the opacities' thickness and calculate the excision depth. Femtosecond laser was then used to create a superficial corneal flap. PTK and smoothening with masking substance (0.25% sodium hyaluronate) were done to improve corneal regularity and decrease corneal scarring. Follow-up was performed at 1, 6, and 12 months. Mean logarithm of the minimum angle of resolution of best spectacle-corrected visual acuity improved from 0.62 (mean decimal 0.26) to 0.30 (mean decimal 0.58) at 1 year (P = 0.035). Haze grades improved significantly. Coma-like aberration decreased postoperatively. Results showed that superficial corneal excision with femtosecond laser augmented with PTK laser smoothening assisted with 0.25% sodium hyaluronate improved visual acuity and could be considered as an alternative to more invasive procedures in patients with severe corneal opacities.