Abstract
This study was aimed to compare visual performance in eyes having femtosecond laser-assisted keratoplasty (FLAK) for grade 4 keratoconus and keratoconic eyes according to the Amsler-Krumeich classification. We comprised 15 eyes of 15 patients undergoing FLAK for grade 4 keratoconus and 69 of 69 keratoconic patients (grade 1; 26 eyes, 2; 17 eyes, 3; 10 eyes, and 4; 16 eyes), and compared best spectacle-corrected visual acuity (BSCVA), corneal astigmatism (CA), corneal densitometry (CD), and corneal higher-order aberrations (CHOAs) using the Scheimpflug rotating camera. BSCVA in the post-FLAK group was significantly better than that in grade 3 or 4 group, but not than that in grade 1 or 2 group. CA was significantly lower than that in grade 3 or 4 group, but not than that in grade 1 or 2 group. CD was significantly higher than that in grade 1, 2, and 3 group, and significantly lower than that in grade 4 group. CHOAs were significantly lower than that in grade 3 or 4 group, but not than that in grade 1 or 2 group. FLAK showed significantly better BSCVA, and less CA and CHOAs, than grade 3 or 4 keratoconus, and showed less CD than grade 4 keratoconus.
Highlights
Our results showed that the post-femtosecond laser-assisted keratoplasty (FLAK) keratoconic group provided significantly better best spectacle-corrected visual acuity (BSCVA), and less corneal astigmatism and higher-order aberrations (HOAs), than the keratoconus grade 3 or grade 4 group, and that it provided less corneal densitometry than the keratoconus grade 4 group
This is the first study to assess the detailed visual performance after FLAK for advanced keratoconus. We believe that this information is clinically helpful for determining the surgical indication of FLAK, especially from the viewpoint of visual quality in keratoconic patients, we did not consider the possible risk of the intraoperative or postoperative complications, such as graft rejection, intraocular pressure rise, a significant endothelial cell loss, or expulsive hemorrhage
Gaster et al demonstrated that BSCVA was 0.44 ± 0.49 logarithm of the minimum angle of resolution (logMAR) and corneal astigmatism was 4.76 ± 3.41 D 6 months after FLAK5
Summary
Our results showed that the post-FLAK keratoconic group provided significantly better BSCVA, and less corneal astigmatism and HOAs, than the keratoconus grade 3 or grade 4 group, and that it provided less corneal densitometry than the keratoconus grade 4 group. Gaster et al demonstrated that BSCVA was 0.44 ± 0.49 logMAR and corneal astigmatism was 4.76 ± 3.41 D 6 months after FLAK5.
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