Comparison of penetrating keratoplasty performed with a femtosecond laser zig-zag incision versus conventional blade trephination.
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.
Farid
Marjan
M
Department of Ophthalmology, The Gavin Herbert Eye Institute, University of California-Irvine, CA 92697, USA.
Steinert
Roger F
RF
Gaster
Ronald N
RN
Chamberlain
Winston
W
Lin
Amy
A
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