Femtosecond laser-assisted deep anterior lamellar keratoplasty using the big bubble technique for keratoconus

Abstract

Objective To evaluate the clinical results and safety of big bubble deep anterior lamellar keratoplasty assisted by a femtosecond laser for keratoconus. Methods A case series of 11 eyes of 9 keratoconus patients were enrolled in the study. A 500 kHz VisuMax femtosecond laser (Carl Zeiss Meditec AG, Jena, Germany) was used to create a vertical side cut on both donor and recipient corneas. The mean thinnest corneal thickness measured with ultrasound corneal pachymetry, was 359.7±49.8 μm. Preoperative UCVA was counting fingers (CF) to-0.1 and preoperative BCVA was CF to-0.12. The mean donor diameter was 7.51±0.14 mm and mean recipient diameter was 7.38±0.10 mm. Mean follow-up was 7.70±2.88 months. Results All eyes were successfully treated without intraoperative complications. Early postoperative evaluation showed a clear graft in all cases. Mean corneal thickness was 481.4±51.3 μm. A normal corneal topographic pattern was restored. At the last postoperative examination, UCVA was 0.15 to 0.40 and the BCVA was 0.30 to 0.80. Conclusion Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty using the big bubble technique shows promise as a safe and effective surgical choice in the treatment of keratoconus. Key words: Keratoconus; Femtosecond laser; Corneal transplantation, deep anterior lamellar; Big bubble