Femtosecond laser-assisted decagonal penetrating keratoplasty.

Abstract

PURPOSE:

To assess the use of a new polygonal trephination pattern for penetrating keratoplasty (PK) assisted by femtosecond laser.

DESIGN:

Prospective, nonrandomized clinical study.

METHODS:

Sixteen eyes underwent decagonal PK. Nine had Fuchs dystrophy, 4 had pseudophakic bullous keratopathy, 1 had experienced trauma, 1 had corneal amyloidosis, and 1 had keratoconus. A Femtec (Tecnolas PerfectVision) laser was used to create decagonal penetrating cuts on both donor and recipient corneas. All patients were evaluated for uncorrected visual acuity, best spectacle-corrected visual acuity, pachymetry, topography, and endothelial cell density. Scanning electron microscopy was performed on corneal tissue after surgery.

RESULTS:

All eyes were treated successfully without intraoperative complications. The mean follow-up ± standard deviation was 9.75 ± 3.5 months. Mean postoperative best spectacle-corrected visual acuity was 20/53, and there was a significant improvement in both uncorrected visual acuity (P = .0019) and best spectacle-corrected visual acuity (P = .001). At 6 months, mean ± standard deviation manifest astigmatism was 1.90 ± 1.20 diopters. Mean endothelial cell density was 1502 ± 458 cells/mm². Scanning electron microscopy displayed straight decagonal cut margins and minor remaining tissue bridges.

CONCLUSIONS:

Use of the decagonal trephination profile was effective and safe to perform PK. Short-term visual results and refractive results are encouraging compared with those of conventional PK studies. Longer-term follow-up and comparative studies are necessary to determine precisely advantages the and optimal surgical settings of this technique.

• Authors: Hélène Proust, Christophe Baeteman, Frédéric Matonti, John Conrath, Bernard Ridings, Louis Hoffart
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 151 Issue 1 Pg. 29-34 (Jan 2011) ISSN: 1879-1891 [Electronic] United States
• PMID: 21047618 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Cell Count
• Cornea (ultrastructure)
• Corneal Diseases (pathology, surgery)
• Corneal Topography
• Endothelium, Corneal (pathology)
• Female
• Humans
• Keratoplasty, Penetrating (methods)
• Laser Therapy (methods)
• Lasers, Solid-State (therapeutic use)
• Male
• Microscopy, Electron, Scanning
• Middle Aged
• Prospective Studies
• Tomography, Optical Coherence
• Visual Acuity (physiology)
• Young Adult