Anatomical and morphological results of modified femtolaser refractive autokeratoplasty in patients with keratoconus

Cover Page

Cite item

Full Text

Abstract

Aim – to evaluate the anatomical and morphological outcomes of modified femtolaser refractive autokeratoplasty in patients with stage II keratoconus.

Material and methods. The study included 24 patients diagnosed with stage II keratoconus according to the Amsler – Krumeich classification. All patients underwent femtolaser refractive autokeratoplasty (FRAK) according to a modified technique.

Results. All operated patients noted an improvement in visual functions on the first day after surgery. The obtained images of optical coherence tomography showed a more uniform posterior profile in the central zone of the cornea, the absence of "folding" of the posterior surface. A characteristic feature of the postoperative period was the change in the depth of the anterior chamber – its pronounced decrease was noted with a tendency to a systematic increase. In 2 months after the removal of suture fixation, the depth of the anterior chamber remained stable throughout the follow-up period. The data of confocal microscopy of the central zone of the cornea after 12 months demonstrated the absence of additional (specific) morphological changes in the cornea. The characteristic morphological changes for keratoconus remained the same as before the FRAK.

About the authors

Aleksandr V. Tereshchenko

S.N. Fedorov Eye Microsurgery Federal State Institution, Kaluga Branch

Email: klg@eye-kaluga.com
ORCID iD: 0000-0002-0840-2675

PhD, director of the Kaluga branch

Russian Federation, Kaluga

Sergey K. Demyanchenko

S.N. Fedorov Eye Microsurgery Federal State Institution, Kaluga Branch

Email: demyan.78@mail.ru
ORCID iD: 0000-0002-0839-2876

PhD, the Head of the Department of Optical Reconstructive and Refractive Surgery

Russian Federation, Kaluga

Maxim A. Timofeev

S.N. Fedorov Eye Microsurgery Federal State Institution, Kaluga Branch

Author for correspondence.
Email: tim.m.a@mail.ru
ORCID iD: 0000-0003-2933-2618

Ophthalmologist

Russian Federation, Kaluga

Elena V. Erokhina

S.N. Fedorov Eye Microsurgery Federal State Institution, Kaluga Branch

Email: Erohus82@mail.ru
ORCID iD: 0000-0001-7320-9209

Head of the Diagnostic Department No.2

Russian Federation, Kaluga

References

  1. Sitnik HV, Slonimsky AYu, Slonimsky YuB. Femtolaser refractive autokeratoplastic: first results and prospects. Ophthalmology in Russia. 2015;12(3):22-29. (In Russ.). [Ситник Г.В., Слонимский А.Ю., Слонимский Ю.Б. Фемтолазерная рефракционная аутокератопластика: первые результаты и перспективы. Офтальмология. 2015;12(3):22-29]. doi: 10.18008/1816-5095-2015-3-22-29
  2. Tereshchenko AV, Trifanenkova IG, Dem'yanchenko SK, et al. Femtosecond laser refractive autokeratoplasty – a personalized approach. Russian Military Medical Academy Reports. 2018;37(2):77-80. (In Russ.). [Терещенко А.В., Трифаненкова И.Г., Демьянченко С.К., и др. Фемтолазерная рефракционная аутокератопластика – персонализированный подход. Известия Российской Военно-медицинской академии. 2018;37(2):77-80]. doi: 10.17816/rmmar14196
  3. Tereshchenko AV, Trifanenkova IG, Dem'yanchenko SK, et al. Femtolaser refractive autokeratoplasty ”FRAK” – clinical experience. Practical medicine. 2018;3(114):182-186. (In Russ.). [Терещенко А.В., Трифаненкова И.Г., Демьянченко С.К., и др. Фемтолазерная рефракционная аутокератопластика «ФРАК» – опыт клинического применения. Практическая медицина. 2018;3(114):182-186].
  4. Tereshchenko AV, Trifanenkova IG, Dem'yanchenko SK, et al. Femtolaser refractive autokeratoplasty for keratoconus – the first experience. Sovremennyye tekhnologii v oftal'mologii. 2017;7(20):95-97. (In Russ.). [Терещенко А.В., Трифаненкова И.Г., Демьянченко С.К., и др. Фемтолазерная рефракционная аутокератопластика при кератоконусе – первый опыт. Современные технологии в офтальмологии. 2017;7(20):95-97].
  5. Timofeyev MA, Tereshchenko AV, Dem'yanchenko SK. Mathematical modeling in the surgical treatment of keratoconus using femtolaser refractive autokeratoplasty. Sovremennyye tekhnologii v oftal'mologii. 2018;4(24):239-241. (In Russ.). [Тимофеев М.А., Терещенко А.В., Демьянченко С.К. Математическое моделирование в хирургическом лечении кератоконуса методом фемтолазерной рефракционной аутокератопластики. Современные технологии в офтальмологии. 2018;4(24):239-241].
  6. Tereshchenko AV, Dem'yanchenko SK, Timofeyev MA. Clinical and functional results of femtolaser refractive autokeratoplasty using a personalized mathematical model in the surgical treatment of keratoconus. Tochka zreniya: Vostok–Zapad. 2019;1:20-22. (In Russ.). [Терещенко А.В., Демьянченко С.К., Тимофеев М.А. Клинико-функциональные результаты фемтолазерной рефракционной аутокератопластики с использованием персонализированной математической модели в хирургическом лечении кератоконуса. Точка зрения: Восток–Запад. 2019;1:20-22]. doi: 10.25276/2410-1257-2019-1-20-22

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Figure 1. Biomicroscopy of the anterior segment of the patient's eye 12 months after FRAK: combined suture fixation, 16 knots and one round of continuous twist suture.

Download (1MB)
3. Figure 2. OCT scan of the anterior segment of the eye: "waviness" of the posterior corneal profile (suture fixation with interrupted sutures).

Download (553KB)
4. Figure 3. OCT scan of the anterior segment of the eye: uniform posterior profile in the central area of the cornea (combined suture fixation).

Download (722KB)
5. Figure 4. Dynamics of changes in the profile of the cornea and the depth of the anterior chamber at different periods of observation.

Download (1MB)
6. Figure 5. Confocal microscopy data of the central corneal zone 12 months after the FRAK.

Download (1MB)
7. Figure 6. OCT of the anterior segment of the eye 12 months after the modified FRAK technique: the formation of a wedge-shaped hyperreflective opacity with a 2/3 depth spread into the thickness of the corneal stroma, pronounced fibrosis of the postoperative scar.

Download (306KB)

Copyright (c) 2022 Tereshchenko A.V., Demyanchenko S.K., Timofeev M.A., Erokhina E.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).