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Femtosecond laser-asissted DALK: different techniques in order to reach big bubble

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First Author: A.Belodedova RUSSIA

Co Author(s):    O. Antonova   B. Malyugin                 

Abstract Details

Purpose:

To describe two different methods of femtosecond laser-assisted deep anterior lamellar keratoplasty (FSL-DALK) and evaluate their safety and effectiveness for the big bubble technique in keratoconic patients.

Setting:

S. Fyodorov Eye Microsurgery Federal Institution, Moscow, Russia

Methods:

61 keratoconic patients (61 eye) underwent FSL-DALK using FEMTO LDV Z8 laser (Ziemer Ophthalmic Systems AG, Switzerland). In 1-st group (n=33) patients underwent regular FSL-DALK procedure. In 2-nd group (n=28) intracorneal channel were additionally created using special lamellar keratoplasty software. The air cannula was then inserted into the stromal channel under microscope-integrated intraoperative OCT control (RESCAN™ 700, Carl Zeiss) and air was injected to achieve a big bubble.We compared the results of big-bubble formation in two groups.

Results:

In first group, without intrastromal channel creation, big bubble was achieved only in 47% of cases, in 37% of cases we had to proceed with manual separation of stromal tissue and 16% of cases were converted into penetrating keratoplasty (PK) due to central o paracentral perforation of Descemet’s membrane. In second group the big bubble was successfully achieved in 19 eyes (67,8%), in 7 cases (25,0%) we had to proceed with manual separation of stromal tissue. In two of these cases (7,2%) the surgery had to be converted into PK. According to performed Fisher’s exact test (p=0,0408) FSL-DALK with intrastromal channels creation (2-nd group) is safer and may be considered as more effective method in case of big bubble technique.

Conclusions:

FSL-DALK with intrastromal channels creation is safe and effective procedure and may be considered as more effective method in case of big bubble technique. It allows to achieve precise surgery and may fasten the general FSL-DALK procedure.

Financial Disclosure:

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