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Femtosecond laser-assisted keratoplasty in keratoconic eyes

Poster Details

First Author: H.Sitnik BELARUS

Co Author(s):                        

Abstract Details

Purpose:

To evaluate the results of keratolpasty in keratoconic patients

Setting:

Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus

Methods:

A prospective study of 63 consecutive patients (65 eyes) was performed (36 men, 27 women, mean age 38.4±6.9 years). The follow-up period varied from 8 month to 3 years. Advanced keratoconus was diagnosed in all cases, cataract in 24 eyes, glaucoma – 4 eyes. All patients underwent a surgical treatment and divided into 2 groups. In 1 group 35 femtosecond laser-assisted PKP were performed (35 eyes, 34 patients), combined with facoemulsification and IOL implantation in 12 cases. 2 group: 30 manual PKP were done (30 eyes, 29 patients), combined with facoemulsification in 12 eyes and IOL implantation in 11 eyes.

Results:

BCVA of patients with no ocular comorbidity ranged from 20/20 to 20/60 at last visit. Mean cylindrical refractive error at last visit was 2.56 D (from 0.50 to 8.00D) in both groups. At 1-3 months post-op OCT scanning showed better graft-host alignment after FS PKP. Endothelial cells density was 1987,5 ± 687,7 (from 1100 to 2600) after FS PKP, 1480,3 ± 208,39 (from 900 to 2400) in eyes after manual PKP at last visit. Rates of intraoperative and postoperative complications were low in both groups. Delayed epithelial healing and increased intraocular pressure which resolved with topical anti-glaucoma drops were observed in 6 eyes. Stromal rejection was diagnosed in 2 cases.

Conclusions:

Femtosecond laser-assisted PKP combined with facoemulsification is safe and predictable procedure. IOL calculation in keratoconic patients requiring simultaneous cataract extraction is challenging problem. Visual outcomes in these cases are comparable in both groups. Better functional results were observed in 1 group in patients without cataract and other comorbidities. Higher endothelial cells density was revealed in 1 group.

Financial Disclosure:

NONE

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