title: Comparison of penetrating keratoplasty performed with a femtosecond laser zig-zag incision versus conventional blade trephination.
abstract: OBJECTIVE
  To evaluate visual outcomes and astigmatism in patients who underwent penetrating keratoplasty (PK) with 2 different incision techniques.
  
  
  METHODS
  Retrospective comparison of a consecutive surgical series.
  
  
  METHODS
  Fifty-seven consecutive patients who underwent PK at the University of California, Irvine, academic referral practice.
  
  
  METHODS
  A comparison of 49 eyes of 43 patients that underwent femtosecond laser zig-zag incision pattern PK versus 17 eyes of 14 patients that underwent conventional Barron suction trephination PK performed contemporaneously. All PKs were closed with an identical, 24-bite running nylon suture technique.
  
  
  METHODS
  Topographically determined astigmatism, best spectacle-corrected visual acuity (BSCVA), and recovery of full visual potential.
  
  
  RESULTS
  The postoperative follow-up ranged from 1 to 12 months. There was a significant difference in average astigmatism between the groups at postoperative month 1 (P = 0.013) and 3 (P = 0.018). By month 3, the average astigmatism was 3 diopters (D) in the zig-zag group and 4.46 D in the conventional group. Of the patients with normal macular and optic nerve function (n(ZZ) = 32; n(con) = 14), a significant difference in BSCVA was seen at month 1 (P = 0.0003) and month 3 (P = 0.006) with 81% of the zig-zag group versus 45% of the conventional group achieving BSCVA of > or =20/40 by month 3 (P = 0.03).
  
  
  CONCLUSIONS
  The femtosecond laser generated zig-zag-shaped incision results in a more rapid recovery of BSCVA and induces less astigmatism compared with conventional blade trephination PK.
  
  
  BACKGROUND
  Proprietary commercial disclosure may be found after the references.
authors: Department of Ophthalmology, The Gavin Herbert Eye Institute, University of California-Irvine, CA 92697, USA.
authors: Marjan
authors: M
authors: Farid
authors: Roger F
authors: RF
authors: Steinert
authors: Ronald N
authors: RN
authors: Gaster
authors: Winston
authors: W
authors: Chamberlain
authors: Amy
authors: A
authors: Lin
mesh_terms: D001251:Astigmatism / Q000503:physiopathology; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000295:instrumentation / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing