Femtosecond laser-assisted deep anterior lamellar keratoplasty for the treatment of stromal corneal pathology

Abstract

Objective To describe the initial outcomes and safety of deep anterior lamellar keratoplasty (DALK) assisted by a femtosecond laser for stromal corneal pathology.Methods In a case series,14 eyes of 13 patients with various stromal corneal diseases (1 eye post-traumatic corneal scar,8 eyes post-keratitis corneal scars and 5 eyes stromal corneal dystrophies) underwent DALK procedures by using a femtosecond laser.The parameters measured include uncorrected visual acuity (UCVA),best-corrected visual acuity (BCVA),endothelial cell density (ECD) and complications.Results All eyes were successfully treated without intraoperative complications.Mean follow-up was 7.3±3.8 months (range,2-14 months).Uncorrected visual acuity improved in 11 eyes compared to preoperative UCVA.The mean difference between preoperative and postoperative UCVAs was a gain of 1.7 lines (range,unchanged-6 lines).Best-corrected visual acuity improved in all eyes compared to preoperative levels.The mean difference between preoperative and postoperative BCVAs was a gain of 2.4 lines (range,1-8 lines).Adjuvant surgical procedures were performed on 3 eyes (treated with phototherapeutic keratectomy),the mean reduction in endothelial cell density was 1％ at the last follow-up.No graft rejection,infection,or epithelial ingrowth was found in this series of pati ents.Conclusion Femtosecond laser-assisted deep anterior lamellar keratoplasty can improve UCVA and BCVA in patients with various stromal corneal pathologies.Our early results indicate that the femtosecond laser produced an effective and smooth dissection through opaque corneas even at deeper settings. Key words: Femtosecond laser; Corneal transplantation; Corneal stromal pathology