title: Femtosecond laser-assisted decagonal deep anterior lamellar keratoplasty.
abstract: OBJECTIVE
  To assess the use of a new polygonal trephination pattern for deep anterior lamellar keratoplasty (DALK) assisted by femtosecond laser.
  
  
  METHODS
  Prospective, nonrandomized clinical study.
  
  
  METHODS
  Twenty-four eyes underwent decagonal DALK. All except 1 had advanced keratoconus. A laser was used to create decagonal cuts on both donor and recipient corneas. All patients were assessed for uncorrected visual acuity, best spectacle-corrected visual acuity (BCVA), and keratometry by Pentacam pre- and postoperatively.
  
  
  RESULTS
  All eyes were treated successfully without intraoperative complications. All patients were followed for 18 months. Mean ± SD of postoperative BCVA was 0.26 ± 0.16 (logarithm of minimal angle of resolution), and there was a significant improvement in BCVA after 6 months. At 18 months, mean ± SD postoperative average K was 44.48 ± 0.87 D, which was significantly lower than preoperative average K (58.42 ± 12.1). Postoperative astigmatism at 18 months (mean ± SD: 1.82 ± 0.67) was significantly lower than that at 6 months (mean ± SD: 3.27 ± 0.81) (p = 0.001).
  
  
  CONCLUSIONS
  Use of the decagonal trephination profile was effective to perform DALK. This study showed promising visual and refractive results. Longer follow-up, larger pool of patients, and comparative studies are necessary to determine advantages and optimal surgical settings of this technique.
authors.affiliation: UPMC Eye Center, Pittsburgh, Pa. Electronic address: espandarl@upmc.edu.
authors.forename: Ladan
authors.initials: L
authors.lastname: Espandar
authors.affiliation: University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Mandell
authors.affiliation: Ordibehesht Eye Center, Shiraz, Iran.
authors.forename: Sasan
authors.initials: S
authors.lastname: Niknam
mesh_terms: D000293:Adolescent; D000328:Adult; D000869:Anterior Eye Segment / Q000601:surgery; D001251:Astigmatism / Q000503:physiopathology; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D063171:Corneal Pachymetry; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult