title: Deep anterior lamellar keratoplasty performed with the femtosecond laser zigzag incision for the treatment of stromal corneal pathology and ectatic disease.
abstract: We describe a variation of the big-bubble deep anterior lamellar keratoplasty (DALK) technique using the femtosecond laser zigzag incision. This technique allows precise depth visualization for air-needle placement in the posterior stroma based on the lamellar and posterior laser cuts, thus minimizing the risk for perforation of Descemet membrane. The matching donor and host tissue zigzag cut allows more precise tissue apposition and greater surface area for healing. The angled anterior donor and host junction allows a smooth transition for improved visual outcomes. If the big-bubble- Descemet membrane dissection fails, the surgeon can convert to a full-thickness graft while retaining the benefits of the femtosecond laser incision.
authors.affiliation: Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California 92697, USA. mfarid@uci.edu
authors.forename: Marjan
authors.initials: M
authors.lastname: Farid
authors.forename: Roger F
authors.initials: RF
authors.lastname: Steinert
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D004108:Dilatation, Pathologic / Q000601:surgery; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000601:surgery*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D013536:Suture Techniques; D041623:Tomography, Optical Coherence; D014792:Visual Acuity