First Author: G.Agorogiannis GREECE
Co Author(s): I. Pallikaris G. Kymionis C. Siganos S. Panagopoulou
Purpose:
To propose a novel cut configuration for femtosecond LASER-assisted penetrating keratoplasty (“N”-shaped incision) and report the early outcomes of the first application with the corresponding LASER parameters and the suturing technique.
Setting:
: Institute of Vision and Optics (IVO), University of Crete Medical School, Greece
Methods:
One patient with keratoconus underwent femtosecond LASER-assisted “N”-shaped penetrating keratoplasty (PK). Alcon WaveLight® FS200 femtosecond LASER device was used to create an “N”-shaped recipient bed and donor button. The “N”-shaped incision pattern consists of a posterior and an anterior vertical to applanated epithelium side cuts, connected by an oblique lamellar ring cut in the stromal bed.
The posterior outer vertical side cut diameter was 9.0 mm starting from anterior chamber towards stroma, with a depth ranging from 550 to 650 microns, extending up to 200 microns from the epithelium. The diameter of the anterior cut was 7.2 mm with a depth of 300 microns from the epithelium, and the “N” overlapping depth (“tooth”) was 150 microns. For the preparation of the donor graft, Barron artificial anterior chamber (Barron Precision Instruments) was used, and the FS200 parameters for anterior and posterior side cut diameters were oversized by 0.2mm. The antero-posterior dimensions of the graft were oversized by 15% due to graft oedema.
Next, graft was sutured in place using four cardinal 10/0 nylon sutures. A running 12-bite 10/0 nylon suture was placed and, finally, the initial sutures have been removed. Needle was guided into the groove of host tissue.
Results:
Excellent alignment and stability of the donor and recipient tissue were observed immediately post-operatively.
Conclusions:
The feasibility of the ‘‘N’’-shaped pattern of PK with Alcon WaveLight® FS200 femtosecond LASER device has been demonstrated.
Financial Disclosure:
None
