title: Comparison of femtosecond laser-assisted descemetic and predescemetic lamellar keratoplasty for keratoconus.
abstract: OBJECTIVE
  The purpose of this study is to compare the outcomes following femtosecond laser-assisted deep anterior lamellar keratoplasty (DALK) with 75% of stromal dissection (predescemetic group) and femtosecond laser-assisted DALK using big-bubble technique with total stromal resection (descemetic group) for the treatment of keratoconus.
  
  
  METHODS
  Twenty eyes of 17 patients with keratoconus were studied. There were 10 eyes of 9 patients in predescemetic group and 10 eyes of 8 patients in descemetic group. The postoperative best-corrected visual acuity (BCVA), manifest refraction, keratometry, endothelial cell density (ECD), and central corneal thickness (CCT) were analyzed.
  
  
  RESULTS
  All surgeries were performed uneventfully. At 1 year after surgery, the BCVA, corneal astigmatism, keratometry, CCT, and ECD between two groups were not statistically significant (all P > 0.05). However, the mean manifest refraction was -9.43 ± 7.44 diopter (D) and -1.03 ± 1.13D in predescemetic and descemetic groups, respectively, which was statistically significant between two groups (P < 0.05).
  
  
  CONCLUSIONS
  The results of BCVA and corneal astigmatism, keratometry, ECD, and CCT were comparable between two groups. However, the mean postoperative manifest refraction was lower in descemetic group.
authors.affiliation: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI 48105, Ann Arbor, MI 48105, USA.
authors.forename: Ana Beatriz Diniz
authors.initials: AB
authors.lastname: Grisolia
authors.affiliation: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Yi-Rui
authors.initials: YR
authors.lastname: Ge
authors.affiliation: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Xue
authors.affiliation: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Cao
authors.affiliation: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Yang
authors.affiliation: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Zhen-Ping
authors.initials: ZP
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002452:Cell Count; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000473:pathology / Q000601:surgery*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D012029:Refraction, Ocular / Q000502:physiology*; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult