Posters

Femtosecond laser-assisted deep lamellar Descemet's membrane endothelial keratoplasty for the treatment of corneal endothelial dysfunction associated with posterior stromal scarring

Poster Details

First Author: V.Vargas Fragoso SPAIN

Co Author(s):    J. Alió del Barrio                    

Abstract Details

Purpose:

To describe an alternative surgical approach, Femtosecond Laser-Assisted Deep Lamellar Descemet Membrane Endothelial Keratoplasty (Femto DL-DMEK), for the treatment of corneal endothelial diseases associated with posterior stromal scarring.

Setting:

Vissum Innovation and Universidad Miguel Hernández, Alicante, Spain

Methods:

Case report of a 52 years old male with pseudophakic bullous keratopathy and severe posterior corneal scarring secondary to viral endotheliitis that underwent Femto DL-DMEK. The surgical technique was as follows:  first, a manual lamellar dissection plane was done at approximately 75-85% depth through a 5.0 mm superior scleral incision. One week later, assisted with femtosecond laser, we created an intersecting posterior side cut of 8.2 mm of diameter. Subsequently, the dissected posterior cornea recipient disc was removed from the anterior chamber through a 3.2mm limbal incision. Finally, an 8.0 mm DMEK graft was placed.

Results:

Patients’ uncorrected distance visual acuity (UDVA) improved from 20/200 (0.15; decimal) preoperatively to 20/30 (0.7) after surgery; corrected distance visual acuity (CDVA) improved from 20/200 (0.15) to 20/25 (0.9) with a residual refraction of +0.5 -0.50@140°; Endothelial cell count was 1930 cell/mm2 twelve months after surgery. No intra or postoperative complications were noted.

Conclusions:

As far as the anterior and mid stroma are unaffected, endothelial diseases associated with opacification of the posterior stroma can benefit from endothelial keratoplasty advantages through a Femto DL-DMEK procedure, avoiding all well-known drawbacks of penetrating keratoplasty.

Financial Disclosure:

None