Abstract
BackgroundTo describe the initial outcomes and safety of anterior lamellar keratoplasty (ALK) assisted by a femtosecond laser for stromal corneal pathology.MethodsA non-comparative case series of 14 eyes (13 patients) with various stromal corneal diseases underwent ALK with a femtosecond laser. Femtosecond laser settings, technique, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and endothelial cell density (ECD) were measured.ResultsAll eyes were successfully treated without intraoperative complications. The UCVA improved in 11 eyes (78.6%) compared with preoperative UCVA. The mean difference between preoperative and postoperative UCVA was a gain of 1.7 lines (range, unchanged to 6 lines). The BCVA improved in all eyes compared with preoperative levels. The mean difference between preoperative and postoperative BCVA was a gain of 2.4 lines (range, 1–8 lines). In 3 eyes, phototherapeutic keratectomy was performed. The mean reduction in endothelial cell density was 3.7% after a mean 7.3 months of follow-up. No graft rejection, infection, or epithelial ingrowth was found.ConclusionsFemtosecond laser-assisted ALK improved UCVA and BCVA in patients with stromal corneal pathology. Our early results indicated that the femtosecond laser produced an effective and smooth dissection through opaque corneas even deeper corneal tissue.
Highlights
To describe the initial outcomes and safety of anterior lamellar keratoplasty (ALK) assisted by a femtosecond laser for stromal corneal pathology
Anterior lamellar keratoplasty (ALK) is a lamellar transplantation surgical technique used for the treatment of corneal diseases that does not affect the endothelium
The purpose of this study was to report the visual outcomes following femtosecond laser-assisted ALK to treat the patients with stromal corneal diseases
Summary
To describe the initial outcomes and safety of anterior lamellar keratoplasty (ALK) assisted by a femtosecond laser for stromal corneal pathology. The donor lamella is positioned directly on Descemet’s membrane, preserving the recipient’s endothelium and decreasing the risk of immunologic rejection [1,2]. This technique has been reported to treat stromal corneal pathology with a good endothelium such as keratoconus [3,4], postrefractive keratectasia [5], stromal dystrophies [6], and anterior corneal scars after trauma or keratitis [7,8]. ALK can be performed manually, semi-mechanized with an automated microkeratome, or with an excimer laser [9] These technologies can result in irregular stromal interface between the donor and recipient lamella. The purpose of this study was to report the visual outcomes following femtosecond laser-assisted ALK to treat the patients with stromal corneal diseases
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