Femtosecond Laser-Assisted Lamellar Keratectomy for Corneal Opacities Secondary to Anterior Corneal Dystrophies: An Interventional Case Series.

Abstract

PURPOSE:

To report results of femtosecond laser-assisted lamellar keratectomy (FLK) for corneal opacities secondary to anterior corneal dystrophies.

METHODS:

Patients with a clinical diagnosis of Reis-Bücklers corneal dystrophy, granular corneal dystrophy, lattice corneal dystrophy, and macular corneal dystrophy were treated. FLK was performed to remove a central corneal free cap of 9.5 mm in diameter at a depth of 110 to 140 μm on which histological analysis was undertaken. Preoperative and postoperative refraction, best spectacle-corrected visual acuity, corneal topography results, and color photographs were recorded. Postoperative in vivo confocal microscopy of the cornea was performed. Changes in uncorrected visual acuity and best spectacle-corrected visual acuity, keratometry, refractive error, corneal irregularity, residual or recurrent central corneal opacities, and corneal haze were used to assess the outcome.

RESULTS:

Eight eyes of 6 patients were treated. The clinical diagnosis was confirmed histologically in all cases. Visual acuity improved significantly from 0.49 ± 0.2 logMAR to 0.14 ± 0.13 logMAR after a mean follow-up of 29 ± 14 (range 8-54) months. Residual central stromal opacities were noted in 5 of 8 eyes immediately postoperatively. Clinically significant recurrence of disease was noted in 1 eye. Keratometry and refraction remained stable, and no further surgical intervention was needed. Patients with stromal corneal dystrophies had worse outcome than those with Reis-Bücklers corneal dystrophy.

CONCLUSIONS:

In this case series, FLK provided both therapeutic and diagnostic intervention, delaying more invasive surgery. In vivo confocal microscopy showed signs of postoperative corneal stromal neuropathy.

• Authors: Bernhard Steger, Vito Romano, Simon Biddolph, Colin E Willoughby, Mark Batterbury, Stephen B Kaye
• Journal: Cornea (Cornea) Vol. 35 Issue 1 Pg. 6-13 (Jan 2016) ISSN: 1536-4798 [Electronic] United States
• PMID: 26509759 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Cornea (pathology)
• Corneal Dystrophies, Hereditary (complications, diagnosis, surgery)
• Corneal Opacity (diagnosis, etiology, surgery)
• Corneal Surgery, Laser (methods)
• Corneal Topography
• Female
• Follow-Up Studies
• Humans
• Lasers, Excimer (therapeutic use)
• Male
• Microscopy, Confocal
• Middle Aged
• Photorefractive Keratectomy (methods)
• Treatment Outcome