Results of penetrating keratoplasty performed with a femtosecond laser zigzag incision initial report.
OBJECTIVE
To determine the initial outcomes of utilizing a femtosecond laser to perform penetrating keratoplasty incisions in a zigzag pattern.


METHODS
Retrospective consecutive surgical series.


METHODS
Patients undergoing full-thickness corneal transplant surgery in a referral academic practice.


METHODS
The IntraLase femtosecond laser performed matching donor and host zigzag incisions in a consistent pattern in 13 eyes of 13 patients.


METHODS
Topographically determined astigmatism, imaging of incisions by anterior segment optical coherence tomography, and best spectacle-corrected visual acuity (BSCVA).


RESULTS
Postoperative follow-up ranged from 3 to 9 months. Mean astigmatism was < or =3.0 diopters (D) at all intervals beginning at 1 month postoperatively. Maximum astigmatism was 4.25 D from month 3 onward. Nine eyes (69%) had < or =3 D and 6 eyes (46%) had < or =2 D by month 3. In the 8 eyes with full vision potential, 7 (87.5%) had BSCVA> or =20/30 by month 3; the eighth eye had improved to 20/25 by month 6. Optical coherence tomography images showed excellent anterior and posterior wound alignment, including one eye where the running suture loosened and was fully removed before month 3.


CONCLUSIONS
The femtosecond laser-generated zigzag incision is biomechanically stable, resulting in excellent wound apposition, wound integrity with minimal suture tension, and recovery of good levels of BSCVA with moderate astigmatism within months of surgery.
Department of Ophthalmology, University of California, Irvine, California 92697-4375, USA.
Marjan
M
Farid
Matthew
M
Kim
Roger F
RF
Steinert
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology; D001251:Astigmatism / Q000503:physiopathology; D003316:Corneal Diseases / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology