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Comparative Study
. 2017 Jan;65(1):19-23.
doi: 10.4103/ijo.IJO_688_16.

Comparison of femtosecond laser-assisted descemetic and predescemetic lamellar keratoplasty for keratoconus

Yan Lu  1 , Ana Beatriz Diniz Grisolia  2 , Yi-Rui Ge  1 , Chun-Yan Xue  1 , Qian Cao  1 , Li-Ping Yang  1 , Zhen-Ping Huang  1
Affiliations
Comparative Study

Comparison of femtosecond laser-assisted descemetic and predescemetic lamellar keratoplasty for keratoconus

Yan Lu et al. Indian J Ophthalmol. 2017 Jan.

Abstract

Purpose: 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.

Subjects and 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.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) The clear and smooth Descemet's membrane was observed after stromal removal in descemetic group. (b) The regular surface of predescemetic plane was detected in predescemetic group
Figure 2
Figure 2
The excellent alignment of Descemet's membrane with the donor tissue was observed through anterior segment optical coherence tomography at 2 days after surgery in descemetic group
Figure 3
Figure 3
The alignment of Descemet's membrane with the donor tissue was detected through anterior segment optical coherence tomography at day 2 postoperatively in predescemetic group
See this image and copyright information in PMC

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