Deep Anterior Lamellar Keratoplasty Combined with Femtosecond Laser in the Management of Keratoconus

Abstract

Purpose: This study was designed to explore the application of femtosecond laser-assisted deep anterior lamellar keratoplasty (DALK) in the management of keratoconus. Methods: A total of 7 patients with keratoconus underwent femtosecond laser-assisted DALK. Femtosecond laser was performed to create corneal cuts on both donor and recipient. Average thinnest corneal thickness was measured with B-mode ultrasound and visual acuity was evaluated by logarithm visual chart. The follow-up endured for (8.9 ± 2.3) months on average, ranging from 12 to 50 months. Results: Corneal pachymetry was measured as (382 ± 44) m, ranging from 381 to 462 m. Mean uncorrected visual acuity (UCVA) was (0.06 ± 0.06) prior to surgery, ranging from 0.01 to 0.15 and mean preoperative best corrected visual acuity (BCVA) was 0.41 ± 0.35 (range: 0.12-1.00). Donor corneal lamellar diameter was measured as 0.22 mm larger compared with that of the recipient. Mean donor corneal lamellar diameter was (7.7 ± 0.3) mm and mean corneal thickness was (371 ± 38) m. A clear graft was noted in all cases after the surgery. Mean corneal thickness was (457 ± 33) m. During final follow-up, mean UCVA was significantly improved to (0.31 ± 0.15) and (0.59 ± 0.23) for mean BCVA. Conclusions: Femtosecond laser-assisted DALK is an efficient and safe treatment of keratoconus.