Visual outcome after conventional and femtosecond laser-assisted DSAEK

Session Details

Session Title: Presented Poster Session: Cornea - Surgical

Session Date/Time: Saturday 05/09/2015 | 15:00-16:30

Paper Time: 15:30

Venue: Poster Village: Pod 4

First Author: : D.Tomdia JAPAN

Co Author(s): :    T. Yamaguchi   S. Shimazaki   Y. Satake   J. Shimazaki     

Abstract Details

Purpose:

To compare short-term visual outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) using grafts prepared with either a femtosecond laser (f-DSAEK) or a microkeratome (m-DSAEK).

Setting:

Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.

Methods:

Thirty-eight eyes that underwent DSAEK in which the grafts prepared with either a femtosecond laser (iFS, AMO, 21 eyes) or a microkeratome (M2, Moria, Antony, 17 eyes) were studied. Visual acuity and regular and irregular astigmatism were compared between the two groups preoperatively and at 1, 3, and 6 months postoperatively. Fourier analysis was conducted using anterior segment optical coherence tomography (AS-OCT) within a 3 mm diameter to calculate astigmatism of the total cornea, anterior and posterior surfaces.

Results:

Visual acuity (logMAR) improved from 1.20 ± 0.60 to 0.43±0.25 6 months after surgery in m-DSAEK (P<0.001), and from 1.20 ± 0.57 to 0.77±0.33 in f-DSAEK (P=0.0028). Visual acuity in the m-DSAEK group was significantly better than f-DSAEK postoperatively (P<0.05). AS-OCT revealed greater irregularities on the posterior surfaces of f-DSAEK grafts compared to m-DSAEK grafts. Irregular astigmatism of the total cornea and the posterior surface were higher in the f-DSAEK group than m-DSAEK at 6 months. There was a significant correlation between postoperative visual acuity and irregular astigmatism of the total cornea, anterior and posterior surfaces (P< 0.02).

Conclusions:

Femtosecond laser has the potential to produce donor grafts for DSAEK with uniform thickness. However, f-DSAEK produced more irregular astigmatism of the posterior surface than m-DSAEK, which degraded optical quality leading to a poor visual outcome.

Financial Interest:

NONE