A new surgical technique: a femtosecond laser-assisted keratolimbal allograft procedure.
OBJECTIVE
To evaluate the feasibility of a femtosecond (FS) laser-assisted keratolimbal allograft (KLAL) technique.


METHODS
Interventional case series.


METHODS
This study included 3 patients with extensive limbal stem cell deficiency. The donor cornea was dissected with an FS laser (IntraLase FS laser, 60 kHz) using a ring procedure, without outer side cutting for the limbal graft, after a penetrated dissection of the donor cornea prior to penetrating keratoplasty (PKP). The depth and width of the ring procedure were adjusted for each individual patient. Further extension to the periphery of the sclerocorneal tissue of the donor graft was performed with a diamond knife. In a case of KLAL alone, the unhealthy limbal tissue of the recipient was removed with the FS laser by the same method employed in donor preparation. One patient underwent KLAL alone, and 2 patients underwent KLAL combined with PKP. The patients were followed up for a maximum of 10 months.


RESULTS
Limbal grafts were even and thin, as expected. The case with KLAL alone showed the fastest epithelization of the recipient cornea. The 2 cases of combined KLAL and PKP showed excellent approximation between recipient and donor tissue. The ocular surfaces have been stable for 8 months in case 1 and 10 months in cases 2 and 3.


CONCLUSIONS
FS laser-assisted KLAL has potential advantages in terms of simplicity and speed as compared with conventional techniques.
Choi
Suk Kyue
SK
Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Korea.
Kim
Jin Hyoung
JH
Lee
Doh
D
Oh
Sae Hoon
SH
D000328:Adult; D002057:Burns, Chemical / Q000601:surgery; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005126:Eye Burns / Q000139:chemically induced; D006801:Humans; D053685:Laser Therapy; D054018:Lasers, Excimer / Q000627:therapeutic use*; D016850:Limbus Corneae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000473:pathology; D014019:Tissue Donors; D014184:Transplantation, Homologous