Clinical results of 123 femtosecond laser-assisted penetrating keratoplasties

Abstract

Femtosecond laser-assisted penetrating keratoplasty is a safe surgical technique. Due to the steps in profiled trephinations, the wound area is larger and theoretically the wound healing is, thus, faster and more stable. Complete suture removal is possible at an earlier time point compared to conventional penetrating keratoplasty. However, refractive results are not superior to those following conventional trephination.

Outcomes of femtosecond laser-assisted mushroom-configuration keratoplasty in advanced keratoconus

“…Despite the high-risk characteristics, visual acuity and refractive outcomes at the final follow-up were comparable to previous studies. 11,12,14 The mean time to complete suture removal was different between PKP and DALK, but is comparable to previous studies of FSL-assisted PKP and DALK. 11,14 Stepped corneal trephination has the advantage of creating a larger surface area at the graft-host interface, leading to improved wound apposition, faster woundhealing, and allowing earlier suture removal.…”

“…11,12,14 The mean time to complete suture removal was different between PKP and DALK, but is comparable to previous studies of FSL-assisted PKP and DALK. 11,14 Stepped corneal trephination has the advantage of creating a larger surface area at the graft-host interface, leading to improved wound apposition, faster woundhealing, and allowing earlier suture removal. 7,8,11,13 With the advent of FSL in keratoplasty, customised configurations could be created with speed and with great precision.…”

“…Birnbaum et al studied 123 FSL-assisted PKP, among which 32 were of mushroom configuration in keratoconus. 11 At a mean of 14.1-month follow-up, they reported significantly better visual acuity and corneal surface irregularity index compared with that of top-hat PKP.…”

“…11,14 Stepped corneal trephination has the advantage of creating a larger surface area at the graft-host interface, leading to improved wound apposition, faster woundhealing, and allowing earlier suture removal. 7,8,11,13 With the advent of FSL in keratoplasty, customised configurations could be created with speed and with great precision. Several different configurations have been studied for their refractive and mechanical attributes.…”

“…9,10 In DALKs, FSL-assisted mushroom-shaped keratoplasty also produces faster visual recovery, allowing earlier suture removal and refractive outcome comparable to manual PKP or FSL-assisted lamellar or PKP. [11][12][13][14][15] Lu et al 16 indicated that FSL-assisted DALK could improve uncorrected and best spectacle corrected visual acuity in patients with keratoconus because of the precise cutting of the donor corneal edge profile and the recipient bed. This approach, although in a small cohort, showed a safe and effective surgical choice in the treatment of keratoconus.…”