Femtosecond laser-assisted anterior lamellar keratoplasty in patients with corneal opacities

The purpose of the study was to explore the possibilities of femtosecond laser-assisted anterior lamellar keratoplasty in patients with corneal opacities of various etiology. Materials and Methods. Femtosecond laser-assisted anterior lamellar keratoplasty (FALK) performed in 8 patients (4 males, 4 females) with superficial corneal opacities at the age from 16 to 20 years. Etiology of corneal opacities: in 3 cases - keratitis of unknown etiology, 2 - herpetic keratitis, 2 - burns, 1 - ulcer. Examination technics: visometry, autorefractometry, biomicroscopy, ophthalmoscopy, tonometry, ultrasonic examination, optical coherence tomography of the anterior segment (OCT), confocal microscopy. Results. A year later all patients showed a clear layering graft retention. One year after surgery corrected visual acuity was on average 0.5 (0.2 - 1.0). According to the anterior segment OCT transplant adaptation was complete in all cases and full compliance with corneal transplant and recipient bed was achieved. In all casestransplants were uniform in all quadrants. According to confocal microscopy data we achieved a healthy graft with good density of keratocytes, normal stroma reflectivity, interface hyperreflektivity and several activated keratocytes. The average of endothelial cells density loss for one year after surgery was 1,8 %, what is comparable to the annual loss of endothelial cells as a result of natural involution processes. Therefore, laser radiation does not have an impact on the cornea deep layers during operation. Conclusions. Femtosecond laser application in the anterior lamellar keratoplasty allows to control all sections parameters (size, shape, depth and location), thereby reducing the risk of intra - and postoperative complications. According to the anterior segment OCT data the thickness of layered graft and the recipient bed was the same in all quadrants after surgery, indicating the precision of this surgical method.

keratoplasty, corneal opacity, femtosecond laser