Femtosecond laser-assisted decagonal penetrating keratoplasty.
OBJECTIVE
To assess the use of a new polygonal trephination pattern for penetrating keratoplasty (PK) assisted by femtosecond laser.


METHODS
Prospective, nonrandomized clinical study.


METHODS
Sixteen eyes underwent decagonal PK. Nine had Fuchs dystrophy, 4 had pseudophakic bullous keratopathy, 1 had experienced trauma, 1 had corneal amyloidosis, and 1 had keratoconus. A Femtec (Tecnolas PerfectVision) laser was used to create decagonal penetrating cuts on both donor and recipient corneas. All patients were evaluated for uncorrected visual acuity, best spectacle-corrected visual acuity, pachymetry, topography, and endothelial cell density. Scanning electron microscopy was performed on corneal tissue after surgery.


RESULTS
All eyes were treated successfully without intraoperative complications. The mean follow-up ± standard deviation was 9.75 ± 3.5 months. Mean postoperative best spectacle-corrected visual acuity was 20/53, and there was a significant improvement in both uncorrected visual acuity (P = .0019) and best spectacle-corrected visual acuity (P = .001). At 6 months, mean ± standard deviation manifest astigmatism was 1.90 ± 1.20 diopters. Mean endothelial cell density was 1502 ± 458 cells/mm². Scanning electron microscopy displayed straight decagonal cut margins and minor remaining tissue bridges.


CONCLUSIONS
Use of the decagonal trephination profile was effective and safe to perform PK. Short-term visual results and refractive results are encouraging compared with those of conventional PK studies. Longer-term follow-up and comparative studies are necessary to determine precisely advantages the and optimal surgical settings of this technique.
Department of Ophthalmology, Aix-Marseille University, Hŏpital de la Timone Adultes, Marseille, France.
Hélène
H
Proust
Christophe
C
Baeteman
Frédéric
F
Matonti
John
J
Conrath
Bernard
B
Ridings
Louis
L
Hoffart
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003315:Cornea / Q000648:ultrastructure; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult