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Inverted posterior femto-keratoplasty: quality of the surface of the corneal section and preliminary clinical results

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First Author: A.Pashtaev RUSSIA

Co Author(s):    B. Malyugin   S. Izmailova   K. Kuzmichev              

Abstract Details

Purpose:

To evaluate the quality of the surface of an ultra-thin donor transplant prepared from the endothelial surface of the cornea using a femtosecond laser and to demonstrate the preliminary clinical outcomes.

Setting:

Eye Microsurgery Federal State Institution by Fedorov

Methods:

All in all, 8 eyes were operated: 5 with Fuch`s dystrophy and 3 with pseudophakic bullous keratopathy. All patients were treated with DSEK with UT graft prepared by Alcon Wavelight FS 200 femtosecond laser (Germany). Before and after surgery UCVA, BSCVA, astigmatism, ECD were measured. EC death, graft thickness and CCT were evaluated at 12 months`observation. 
Atomic force microscopy was used for examination of 10 samples. Control group was 5 corneal grafts obtained by mechanical microkeratome (Moria SLK-2, France). Main group — 5 grafts, obtained by femtosecond laser. Nonparametric Mann-Whitney test was used for statistical analysis.

Results:

RMS value of femto-laser group samples was 18,6±7,8 um. RMS of microkeratome group samples was 22,3±18,3 um. Statistical analysis did not reveal significant differences between the values of the studied parameter in these groups (p>0,05).
Transparent engraftment was observed in all cases, no corneal edema was identified. BSCVA ranged from 0,2 to 0,7, and was limited by the presence of concomitant pathology. Astigmatism was 1,3±1 D. ECD = 1545±362 cells/mm2. EC loss = 46±11,3%. Graft thickness in the central zone was 79±16,3 µm. Center-Edge Index — 0,84±0,1. CCT = 580±27 um. No postoperative complications were found.

Conclusions:

The developed settings allowed to obtain high-quality ultra-thin graft with a sufficiently uniform surface without a risk of perforation. Preliminary clinical results showed the method potential for restoration of corneal transparency. ECD loss corresponded to the one achievable by DSAEK.

Financial Disclosure:

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