Femtosecond laser–assisted descemetorhexis for Descemet membrane endothelial keratoplasty: cell-based and tissue-based ex vivo analysis of precision and safety

Feldhaus, Lukas; Dirisamer, Martin; Ohlmann, Andreas; Luft, Nikolaus; Kassumeh, Stefan; Shajari, Mehdi; Priglinger, Siegfried; Mayer, Wolfgang J.

doi:10.1097/j.jcrs.0000000000000692

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…5,6 The femtosecond incisions were found to cause minimal endothelial damage. 7 Our group has also shown reduced endothelial cell loss (ECL) in F-DMEK compared with M-DMEK over the early postoperative period. 6 To the best of our knowledge, there are no published data on 5-year safety and efficacy of F-DMEK.…”

mentioning

confidence: 73%

“…Feldhaus et al 7 recently performed a cell-based and tissue-based ex vivo analysis of the influence femtosecond descemetorhexis has on the endothelium and found that the laser has a minimal impact on the vitality of the treated tissue, especially regarding the corneal endothelium. Compared with M-DMEK, the F-DMEK procedure seems to induce less ECL in patients with FED.…”

Section: Discussionmentioning

confidence: 99%

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Five-Year Safety and Efficacy of Femtosecond Laser–Assisted Descemet Membrane Endothelial Keratoplasty

Sorkin

Gouvea

Din

et al. 2022

Cornea

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The purpose of this study was to evaluate 5-year safety and efficacy outcomes of femtosecond-enabled Descemet membrane endothelial keratoplasty (F-DMEK) in patients with Fuchs' endothelial dystrophy (FED).Methods: This was a retrospective study, including patients with FED and cataract who underwent either F-DMEK (16 eyes of 15 patients) or manual DMEK (M-DMEK) (42 eyes of 37 patients) combined with cataract extraction. Outcome measures included visual acuity, graft detachment, graft survival, and endothelial cell loss. Results:The average follow-up in F-DMEK and M-DMEK was 57.1 6 12.4 months and 58.5 6 17.3 months, respectively (P = 0.757). The rates of primary failure (0% vs. 9.5%, P = 0.567), secondary failure (0% for both), and graft rejection (0% vs. 7.1%, P = 0.533) did not differ significantly between the groups. Improvement in best spectacle-corrected visual acuity was similar in F-DMEK and M-DMEK (0.32 6 0.27 logarithm of the minimum angle of resolution and 0.35 6 0.44 logarithm of the minimum angle of resolution, respectively, P = 0.165) and persisted at 2, 3, 4, and 5 years and at the last follow-up. The rates of graft detachment and rebubbling were significantly lower with 6.25% in F-DMEK and 33.3% in M-DMEK (P = 0.035). Cell-loss rates were lower in F-DMEK compared with M-DMEK throughout the follow-up, significantly so up to 2 years with a difference of 8.6% at 1 year (P = 0.023), 11.8% at 2 years (P = 0.021), 7.6% at 3 years (P = 0.088), 5.8% at 4 years (P = 0.256), 13.6% at 5 years (P = 0.169), and 7.1% at the final follow-up (P = 0.341).Conclusions: F-DMEK had an excellent safety and efficacy profile which was maintained over 5 years of follow-up. Lower endothelial cell-loss rates in F-DMEK compared with M-DMEK may help extend the duration of graft survival.

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mentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Five-Year Safety and Efficacy of Femtosecond Laser–Assisted Descemet Membrane Endothelial Keratoplasty

Sorkin

Gouvea

Din

et al. 2022

Cornea

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“…[ 66 ] In DMEK, FSL can enable descemetorhexis with desired size and depth with excellent accuracy that results in the precise apposition between host and donor endothelial tissue without graft-host tissue overlap, which may be associated with a reduced risk of graft detachment and rebubbling. [ 14 , 15 , 67 ] Sorkin et al . [ 68 , 69 ] reported that FSL-assisted DMEK showed excellent efficacy and safety over 5 years of follow-up.…”

Section: Femtosecond Laser-assisted Endothelial Keratoplastymentioning

confidence: 99%

Advantages of femtosecond laser in various corneal transplantation procedures: A narrative literature review

Han

2023

Taiwan Journal of Ophthalmology

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The ability of the femtosecond laser (FSL) to create tissue incisions at desired depth and location with minimal collateral damage to surrounding tissue may offer potential advantages for corneal transplantation surgery. FSL may enable the precise and accurate preparation of both donor and recipient tissue, which can potentially result in enhanced wound integrity, facilitation of wound healing, and improved visual outcomes. Many studies have suggested that FSL may be a viable option in various corneal transplantation procedures, such as, penetrating keratoplasty, anterior lamellar keratoplasty, endothelial keratoplasty, and novel techniques, including Bowman layer transplantation and stromal lenticule addition keratoplasty. In this review, the author presents a brief overview on the application of FSL in various corneal transplantation procedures and discusses the results of studies regarding the safety and efficacy of FSL-assisted corneal transplantation procedures.

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Femtosecond Descemet Membrane Endothelial Keratoplasty

Sorkin,

Rootman,

Mimouni

2023

Essentials in Ophthalmology

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Femtosecond laser–assisted descemetorhexis for Descemet membrane endothelial keratoplasty: cell-based and tissue-based ex vivo analysis of precision and safety

Abstract: To analyze precision and safety of femtosecond laser-assisted descemetorhexis and postoperative corneal wound healing in human ex vivo specimens.

Cited by 3 publications

References 28 publications

Five-Year Safety and Efficacy of Femtosecond Laser–Assisted Descemet Membrane Endothelial Keratoplasty

Five-Year Safety and Efficacy of Femtosecond Laser–Assisted Descemet Membrane Endothelial Keratoplasty

Advantages of femtosecond laser in various corneal transplantation procedures: A narrative literature review

Femtosecond Descemet Membrane Endothelial Keratoplasty

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