Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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A new combined technique of deep intrastromal arcuate keratotomy with in situ keratomileusis (DIAKIK) for the treatment of high astigmatism in a post-keratoplasty context

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Session Details

Session Title: Moderated Poster Session: Hot Topics in Refractive Surgery

Session Date/Time: Saturday 10/09/2016 | 14:00-15:00

Paper Time: 14:40

Venue: Poster Village: Pod 1

First Author: : O.Levy FRANCE

Co Author(s): :    P. Loriaut   L. Jouve   C. Temstet   V. Borderie   N. Bouheraoua   L. Laroche

Abstract Details


To evaluate a new technique of Deep Intrastromal Arcuate Keratotomy with In Situ Keratomileusis (DIAKIK) followed by excimer photoablation to correct post-keratoplasty (PK) high astigmatism and ametropia.


Prospective interventional uncontrolled case series at Quinze-Vingts National Ophthalmology Hospital, Paris, France.


Patients with PK high astigmatism and ametropia underwent a two-steps procedure. The first step was deep intrastromal arcuate keratotomy with lamellar keratotomy (corneal flap) at 130 ┬Ám depth by femtosecond laser. The corneal flap was manually lifted and deep intrastromal incisions were rinsed. At least one month later, after refraction and topography stabilization, the second step consisted in reopening the flap and using an excimer laser to correct residual ametropia. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean cylinder after each step.


The study included 15 eyes of 15 patients with high PK astigmatism and ametropia (8 penetrating keratoplasties and 7 deep lamellar anterior keratoplasties). The mean cylinder reduced from 6.69 +/- 2.38 (SD) diopters (D) preoperatively to 2.7 +/- 1.32 D postoperatively. The mean UDVA and CDVA improved respectively from 1.13 +/- 0.56 logMAR and 0.36 +/- 0.28 logMAR preoperatively to 0.53 +/- 0.35 logMAR and 0.21 +/- 0.24 logMAR respectively postoperatively. The mean correction index was 0.98 +/- 0.19 and the mean flattening index was 0.92 +/- 0.19 for the two-steps procedure. No complications were observed.


DIAKIK procedure followed by excimer photoablation is a safe and effective technique for management of high PK astigmatism and ametropia. Larger series of patients and longer follow-up should confirm these results and determine long-term benefits.

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