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Session Title: Corneal Femtosecond
Session Date/Time: Monday 07/10/2013 | 14:30-16:30
Paper Time: 15:40
Venue: Elicium 1 (First Floor)
First Author: : O.Oganesyan RUSSIA
Co Author(s): : V. Neroev R. Gundorova A. Penkina
To study the short term results of Femtosecond laser Descemet"s Stripping Endothelial Keratoplasty from endothelial side (invert FS-DSEK) at the first 6 patients with pathology of endothelium.
Department of Traumatology and Reconstructive Surgery of The Helmholtz Moscow Research Institute of Eye Diseases
Of the 6 patients, 2 were women and 4 men. The mean age was 60 years (from 34 to 81). In 3 cases, there was the endothelial failure after PK, in 2 cases was PBK, in 1 case - Fuchs" dystrophy. Two patients had artificial lens-iris diaphragm and were operated glaucoma with Ahmed implant. There were also paralytic mydriasis, pupil fixated IOL, postrupture scar of the sclera. Preoperative BCVA was 0.04 (0,01 -0.05). Follow-up was 6 months. Invert FS-DSEK performed with a femtosecond laser LDV Z6. Intraoperative depth of femtodisruption (from endothelial side) was 150 microns. The average diameter of the graft was 9 mm (8.0 - 9.5). Graft insertion into the anterior chamber performed with forceps. Six months postop we have studied BCVA, performed biomicroscopy, OCT and Scheimpflug analyzer of the cornea, and endhothelial microscopy with manual count of ECD. Because of the hard preop neuroretinal pathology in most cases DSEK was performed mainly for therapeutic reason.
There was a graft detachment (performed to rebubbling) in 1 case. There was a partial detachment in 1 case, which didn`t require the rebubbling. Six months after surgery all corneal were transparented without any graft detachment. Average BCVA was 0.2 (0.05 - 0.4). The mean ECD was 1373 cell/mm2 (500-2345 cell/mm2). Average graft central thickness according to OCT was 90,7 microns. The difference between the central and peripheral thickness of the graft was less than 20 microns.
Endothelial side (invert) femtodistruption is safe and secure procedure to achieve uniform and ultrathin graft with viable endothelium. The frequency of tissue loss is zero, and postoperative complications are minimal.
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