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Comparative Study
. 2012 Sep;96(9):1195-9.
doi: 10.1136/bjophthalmol-2012-301662. Epub 2012 Jul 11.

Penetrating keratoplasty using femtosecond laser-enabled keratoplasty with zig-zag incisions versus a mechanical trephine in patients with keratoconus

Ronald N Gaster  1 , Oanna Dumitrascu, Yaron S Rabinowitz
Affiliations
Comparative Study

Penetrating keratoplasty using femtosecond laser-enabled keratoplasty with zig-zag incisions versus a mechanical trephine in patients with keratoconus

Ronald N Gaster et al. Br J Ophthalmol. 2012 Sep.

Abstract

Background/aims: This paper will compare the visual outcomes of two different penetrating keratoplasty (PKP) techniques in patients with keratoconus. It is a retrospective comparative surgical case series of 116 keratoconus patients (137 eyes) who had PKP at the Cornea Eye Institute, Beverly Hills, California, USA.

Methods: 56 keratoconus patients (66 eyes) underwent femtosecond laser-enabled keratoplasty (FLEK) with a zig-zag incision configuration. Their visual parameters were compared with those of 60 patients (71 eyes) who had traditional blade mechanical trephination PKP. The range of follow-up was between 3 and 6 months. The main outcome measures included uncorrected visual acuity and best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent and topographically determined astigmatism.

Results: BSCVA was significantly better as early as 3 months postoperatively (p=0.001) in the FLEK group. Visual recovery to 20/40 after 3 months was significantly better in the FLEK group (p<0.001). Topographic astigmatism was lower in the FLEK group, but the difference between the two groups reached significance only at 3 months of follow-up (p=0.001). Postoperative complications noted were not different between the two groups.

Conclusions: Faster visual recovery and better long-term outcomes were observed in keratoconus patients who had FLEK compared with those who had the mechanical PKP procedure with 6 months of postoperative follow-up.

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Figures

Figure 1
Figure 1
Femtosecond laser parameters used for corneal transplant.
Figure 2
Figure 2
Time dynamic of topographically determined astigmatism (dioptres) (p=0.001). FLEK, femtosecond laser-enabled keratoplasty; PKP, penetrating kemtoplasty.
Figure 3
Figure 3
Diagram of femtosecond laser-enabled keratoplasty zig-zag incision.
See this image and copyright information in PMC

References

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