Femtosecond dovetail penetrating keratoplasty: surgical technique and case report.
OBJECTIVE
To report a dovetail configuration for femtosecond-enabled penetrating keratoplasty (PK) with the corresponding laser parameters and suturing technique.


METHODS
A 40-year-old man, with a history of penetrating corneal injury as a child, underwent femtosecond-enabled dovetail keratoplasty, anterior vitrectomy and secondary intraocular lens suturing to repair his corneal scar and aphakia. A partial thickness dovetail pattern was performed in the recipient cornea using the femotsecond laser. The posterior side-cut was initiated approximately 100 microm anterior to the Descemet membrane and extended obliquely towards the outer edge of a ring lamellar cut, positioned at approximately 300 microm stromal depth. The anterior side-cut was extended from the internal edge of the ring lamellar cut to the corneal surface. Using an artificial chamber, the femtosecond laser was used to create a full-thickness 0.2 mm oversized femtosecond-enabled dovetail trephination with similar anterior lamellar depth (approximately 300 microm). Wound closure, using interrupted 10-0 nylon sutures, was guided by preplaced radial alignment laser microincisions and tongue-in-groove midstromal suture positioning.


CONCLUSIONS
Excellent alignment and stability of the donor and recipient tissue were observed immediately postoperatively and 5 months after surgery. The feasibility of the "dovetail" pattern of PK and the tongue-in-groove suture positioning is demonstrated.
Lee
J
J
Department of Ophthalmology and Visual Sciences, Illinois Eye Ear Infirmary, University of Illinois, Chicago, IL 60612, USA.
Winokur
J
J
Hallak
J
J
Azar
D T
DT
D000328:Adult; D000550:Amblyopia / Q000601:surgery*; D019781:Corneal Topography; D015807:Eye Injuries, Penetrating / Q000601:surgery*; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy