Preliminary results of femtosecond laser-assisted descemet stripping endothelial keratoplasty.
OBJECTIVE
To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK).


METHODS
We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK. Corneal thickness was measured using an optical coherence tomography technique.


RESULTS
The average BSCVA of 11 eyes with normal visual potential significantly improved from 20/110 +/- 4 lines to 20/57 +/- 1 line at 6 months (P < .007). At 6 months, the mean (SD) hyperopic shift was 2.24 (2.3) diopters (D). Preoperative and 6 months postoperative refractive astigmatism were -0.75 (0.9) D and -1.58 (1.1) D (P = .01), but the topographic astigmatism did not change postoperatively (P = .95). Mean (SD) endothelial cell density at 6 months was 1368 (425) cells/mm(2). There was a persistent deswelling of the graft up to 3 months postoperatively. Complications included graft dislocations requiring repositioning (20%), pupillary block glaucoma (5%), epithelial ingrowth (5%), and primary graft failure (5%).


CONCLUSIONS
Femtosecond laser-assisted Descemet stripping endothelial keratoplasty was effective in treating endothelial failure with minimal induced refractive astigmatism, limited improvement of BSCVA, and induction of a hyperopic shift. Endothelial cell count and dislocation rate were significant, which may be related to the surgical technique.
Department of Ophthalmology, University Hospital Maastricht, Maastricht, the Netherlands.
Yanny Y Y
YY
Cheng
Fred
F
Hendrikse
Elisabeth
E
Pels
Robert-Jan
RJ
Wijdh
Hugo
H
van Cleynenbreugel
Cathariena A
CA
Eggink
Gabriel
G
van Rij
Wilhelmina J
WJ
Rijneveld
Rudy M M A
RM
Nuijts
D000368:Aged; D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery; D048988:Corneal Surgery, Laser / Q000379:methods*; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000601:surgery / Q000637:transplantation; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005642:Fuchs' Endothelial Dystrophy / Q000175:diagnosis / Q000601:surgery*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014792:Visual Acuity