Posters

Clinical outcomes of OCT-guided femtosecond laser-assisted DALK with intracorneal channel to create big bubble

Poster Details

First Author: A.Belodedova RUSSIA

Co Author(s):    O. Antonova   M. Melnik   A. Gelyastanov   B. Malyugin           

Abstract Details

Purpose:

To evaluate clinical and functional outcomes of the femtosecond laser-assisted deep anterior lamellar keratoplasty (FSL-DALK) with OCT-guided channel created for the big bubble technique

Setting:

S. Fyodorov Eye Microsurgery Federal Institution, Moscow, Russia

Methods:

28 keratoconic patients (28 eyes) underwent FSL-DALK with channel creation for the big bubble technique using FEMTO LDV Z8 laser (Ziemer Ophthalmic Systems AG, Switzerland). Intracorneal channel were created in deep stroma 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 Meditec Inc.) and air was injected to achieve a big bubble. Best corrected visual acuity (BCVA), corneal pachimetry, endothelial cell density (ECD), surface asymmetry index (SAI), and intraoperative and postoperative complications were evaluated during the follow up period of 9 month.

Results:

Perforation of Descemet membrane occurred intraoperatively in 2 patients (7,1%). BCVA before surgery was 0,09±0,08.Following the surgery BCVA was 0,20±0,11; 0,31±0,19; 0,35±0,17; 0,42±0,20 and 0,46±0,21 1st week, 1, 3, 6 and 9 months postop.Central corneal pachymety values preoperatively were 357,2±31,2µm and 546,5±53,8µm; 525,4±39,7µm; 521,4±33,1µm; 524,9±35,98µm; 522,0±41,7in the above-mentioned intervals.ECD before surgery was 2102,1±334,5 cells/sq.mm, and became 1876±513,4 cells/sq.mm at 9 months respectively.Surface asymmetry index (SAI) was evaluated preoperatively and at 9 months postop and decreased from 4,58±1,61 to 1,69±0,82.

Conclusions:

FSL-DALK with OCT-guided tunnel creation is a safe and effective method for big bubble formation, allowing to achieve precision of the surgery and to receive satisfactory clinical and functional results in keratoconic patients.

Financial Disclosure:

None