Femtosecond laser-assisted sutureless transplant for keratoconus with six month follow-up

Session Details

Session Title: Surgical Cornea: Keratoplasty & Corneal Grafts

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 15:30

Venue: Room A3, Podium 3

First Author: : K.Pradhan NEPAL

Co Author(s): :    D. Reinstein   R. Vida   T. Archer   G. Carp           

Abstract Details

Purpose:

To describe the technique of a femtosecond laser assisted sutureless transplant and report on the 6 month outcomes.

Setting:

London Vision Clinic, London, UK

Methods:

A 20 year old male with a history of keratoconus presented for evaluation at Tilganga Institute of Ophthalmology, Nepal. The patient had previously undergone a DALK in the left eye. The CDVA in the right eye was 20/80 with a manifest refraction of -5.00 -3.50 x 170 and pachymetry of 425 µm. A donor graft was prepared using the VisuMax. A myopic ablation was performed with the MEL 80 excimer laser. A SMILE lenticule was created in the recipient and extracted through a 3 mm small incision. The donor graft was inserted, smoothed and centered, with no sutures being used.

Results:

Six months postoperatively, UDVA was 20/80 and CDVA was 20/32 with a manifest refraction of -1.50 -4.00 x 125. Corneal topography showed a centered graft with regular astigmatism. The mean keratometry had decreased from 57.28 D to 54.99 D with the steep keratometry reading decreasing from 62.82 D to 56.96 D. The minimum corneal thickness had increased to 625 µm.

Conclusions:

Femtosecond assisted sutureless transplants may be another option to improve the quality of vision in keratoconic patients. The procedure may offer a treatment that is shorter, less risky, and more accurate compared to anterior lamellar or full thickness transplantation. This single case report should encourage further studies to establish the full risk profile as well as possible elebility (i.e. thin very thin corneas, scarred corneas) for future patients.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented