Femtosecond laser-assisted lamellar keratoplasty: early results.
OBJECTIVE
To evaluate the outcomes and safety of lamellar keratoplasty (LK) assisted by a femtosecond laser.


METHODS
Twenty-one eyes of 21 patients affected by different corneal pathologies (5 posttraumatic corneal scar, 3 postkeratitis corneal leucoma, and 13 keratoconus) underwent LK procedures by using a femtosecond laser. The mean thinnest corneal thickness, evaluated with ultrasound corneal pachymetry and with confocal microscopy, was 434.19 +/- 62.60 (SD) microm (range, 333-548 microm). Mean preoperative uncorrected visual acuity was 0.09 +/- 0.28 SD and mean preoperative best spectacle-corrected visual acuity was 0.28 +/- 0.15 SD. A femtosecond laser was used to perform corneal cuts on both donor and recipient corneas. The donor corneal lamella diameters were 0.20-mm larger and thicker than the recipient to restore a physiologic corneal thickness and shape: mean donor diameter was 8.34 +/- 0.28 mm (range, 8.2-8.7 mm) and mean thickness was 352 +/- 40.27 microm (range, 220-400 microm). Mean follow-up was 20.86 +/- 5.76 months (range, 12-30 months).


RESULTS
Early postoperative evaluation showed a clear graft in all cases. A normal corneal pattern topography and a physiologic thickness (mean corneal pachymetry, 542.48 +/- 33.20 microm) and transparency were restored. Twelve months after surgery, the mean postoperative uncorrected visual acuity was 0.45 +/- 0.34 SD, and the mean best spectacle-corrected visual acuity was 0.63 +/- 0.16 SD.


CONCLUSIONS
Although the numbers in our study are small, our early results indicate that femtosecond laser-assisted lamellar keratoplasty shows promise as a safe and effective surgical choice in the treatment of various corneal pathologies.
Mosca
Luigi
L
Catholic University of Sacro Cuore, A. Gemelli Polyclinic Eye Clinic, Rome, Italy. l.mosca@tin.it
Fasciani
Romina
R
Tamburelli
Ciro
C
Buzzonetti
Luca
L
Guccione
Laura
L
Mandarà
Erika
E
Balestrazzi
Emilio
E
D000293:Adolescent; D000328:Adult; D002648:Child; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity