Comparison of femtosecond laser-assisted deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconusReport as inadecuate

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BMC Ophthalmology

, 15:144

First Online: 27 October 2015Received: 30 November 2014Accepted: 19 October 2015


BackgroundTo compare outcomes of femtosecond laser-assisted deep anterior lamellar keratoplasty FSL-DALK and penetrating keratoplasty FSL-PK for the treatment of keratoconus.

MethodsTwenty eight eyes underwent FSL-DALK consisted of 12 eyes in the FSL-DALKa subgroup without baring the Descemet’s membrane and 16 eyes in the FSL-DALKb subgroup baring the Descemet’s membrane using big-bubble technique were compared with 12 eyes that underwent FSL-PK for keratoconus. These patients underwent an ophthalmic examination preoperatively and 3, 6, 9, and 12 months postoperatively.

ResultsThe postoperative BCVA in the FSL-PK group, and the FSL-DALKb subgroup were significantly better than that in the FSL-DALKa subgroup P < 0.05, whereas no differences were found between the FSL-DALKb subgroup and the FSL-PK group P > 0.05. There were no significant differences in the mean spherical equivalent SE and astigmatism between the FSL-DALK and the FSL-PK groups, nor between the subgroups of FSL-DALK during the follow-up period P > 0.05. At the last follow-up, the mean endothelial cell loss in the FSL-DALK group 9.12 % was significantly less than that in the FSL-PK group 20.79 % P < 0.001, while there was no difference between the FSL-DALKa 9.15 % and the FSL-DALKb 9.10 % subgroups P = 0.15. The FSL-DALK group seemed to have fewer graft rejections 1-28 cases than the FSL-PK group 2-12 cases, although Kaplan-Meier curve showed no significant difference between the two groups P = 0.144.

ConclusionsIn this retrospective study, the results suggested that FSL-DALKb gives better visual outcome, and FSL-DALKb is a better option for keratoconus whose endothelium is not compromised. However, larger and prospective studies are further required.

KeywordsFemtosecond laser-assisted deep anterior keratoplasty Femtosecond laser-assisted penetrating keratoplasty Keratoconus Baring Descemet’s membrane AbbreviationsFSL-DALKFemtosecond laser-assisted deep anterior lamellar keratoplasty

FSL-PKFemtosecond laser-assisted penetrating keratoplasty

BCVABest-corrected visual acuity

DMDescemet’s membrane

LogMARLogarithm of the minimum angle of resolution

OCTOcular coherence tomography

SESpherical equivalent

ECDEndothelial cell density

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Author: Yueqin Chen - Dan-Ning Hu - Yuan Xia - Liping Yang - Chunyan Xue - Zhenping Huang


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