Posters

Femtosecond laser-assisted refractive autokeratoplasty in advanced keratoconus: early results

Poster Details

First Author: H. Sitnik BELARUS

Co Author(s):    A. Slonimsky   Y. Slonimsky   T. Imshenetskaya              

Abstract Details

Purpose:

To develop a new method of refractive autokeratoplasty with the use of femtosecond laser in patients with advanced keratoconus and to evaluate the early clinical outcomes of this treatment.

Setting:

Ophthalmology Department, Belarusian Medical Academy of Post-Graduate Education, Minsk

Methods:

19 patients with keratokonus were included in the study (17 men, 2 women) mean age 33 ± 8.1 years old. Stage III of keratokonus was diagnosed in 3 eyes, stage IV in 16. Minimal corneal thickness was 381 ± 33.82 µм, keratometric indices Ks 59.1±5.7 D, Kf 54.8 ± 5.8 D, cylinder 9.1 ± 3.8 D. Femtolaser-assisted refractive autokeratoplasty (FRAK) was performed using «IntraLase 60 kHz». The idea of our method consists in flattening of conic cornea when performing of 2-step resection of corneal stroma using femtosecond laser. After flap removal corneal wound is suturing with single buried sutures 10-0.

Results:

Operation and early post-op period were uneventful. Mean UCVA significantly improved from 0.07±0.03 to 0.26±0.13 to 3 months after surgery. Between 3 to 6 months after surgery, we observed an increase of visual functions (like UCVA and BCVA). The improvement of UCVA was observed in 94.7% and in 57.8% of cases the increase was more than 3 lines. BCVA improved in 84.2%. The cylindrical component decreased from 9.1 ± 3.8 to 4.4 ± 2.75 D. No significant changes in endothelial cell density were observed from 3 to 6 months after surgery (p>0.05), with a mean 6-month postoperative value of 2569.0 ± 113.8 cell/mm2.

Conclusions:

FRAK is a new method for the treatment of stable advanced keratoconus, which helps to improve optical capacity of cornea, allows saving the patient's cornea instead of corneal transplantation, improve both UCVA and BCVA. The use of femtosecond laser for corneal stroma resection provides high accuracy and predictability. Further researches are needed to determine long-term outcomes.

Financial Disclosure:

NONE