SELECTIVE KERATOPLASTY USING THE FEMTOSECOND LASER

Objective: is to assess the reproducibility of the technique of deep anterior lamellar keratoplasty and posterior lamellar keratoplasty using the femtosecond laser. Materiasls and methods. We analyzed the results of posterior lamellar keratoplasty with ultrathin graft and deep anterior lamellar keratoplasty using the femtosecond laser, conducted in the period from 2016 to 2018. Endothelial keratoplasty was performed in 85 eyes of 80 patients. The mean age of patients was 68 ± 12 years. Deep anterior layered keratoplasty was performed in 63 eyes of 61 patients. The mean age of patients was 28 ± 7 years. In the pre- and postoperative period, a complex highly informative ophthalmological examination was carried out. All operations were performed with the femtosecond laser support device on the unit «Femto LDV Z8» ( Ziemer , Switzerland). Results of the study. In patients after endothelial femtokeratoplasty, visual acuity without correction 1 month after the surgery was 0.21 ± 0.03, 6 months after surgery visual acuity was 0.3 ± 0.1 and 12 months - 0.35 ± 0.15. Best corrected visual acuity was 0.25 ± 0.05 1 month after the surgery, 0.5 ± 0.13 - 6 months and 0.55 ± 0.15 - 12 months after the surgery. Endothelial cell loss over 12 months was 21.5 ± 3.7 percent in average. In patients after deep anterior lamellar keratoplasty in a period of 6 months, visual acuity without correction was 0.35 ± 0.05, the GOAT - 0,55 ± 0,1. In 9 months after surgery, the visual acuity without correction was 0.37 ± 0.03, best corrected visual acuity - 0.6 ± 0.15. In a period of 12 months after the operation, visual acuity without correction was 0.35 ± 0,06, best corrected visual acuity was at the level of 0.62 ± 0.15. The value of astigmatism within 6 months after the surgery varied within 3.5 ± 1.0 diopters, and after 12 months astigmatism was 3.0 ± 1.1. Endothelial cell loss during 12 months was 3.4 ± 1.2% in average. Conclusion. The use of a femtosecond laser for various types of keratoplasty could be the basis for the formation of the modern standards of corneal surgery (bibliography: 7 refs).

deep anterior lamellar keratoplasty, femtosecond laser, posterior lamellar keratoplasty with ultrathin graft