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Femtosecond laser-assisted circular keratotomy(CKT) to halt progression of keratoconus Stage I and II

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Session Details

Session Title: Cornea - Surgical III

Session Date/Time: Sunday 06/09/2015 | 14:15-16:15

Paper Time: 14:27

Venue: Room 16

First Author: : J.Krumeich GERMANY

Co Author(s): :    D. Breyer   D. Hirnschall                 

Abstract Details


To evaluate outcomes and practicability of Femtosecond Laser cut CKT in comparison to the same method in which a trephine was used to create a circular scar, 246 eyes of the trephine group are retrospectively analysed and compared with 42 eyes of the Femto group. Statistical evaluation is provided comparing both procedures.


Clinic Krumeich, Bochum, Germany


A 7mm in diameter circular incision around the optical axis is created. In the trephine group the Guided Trephine System(GTS) was used to create the cut of 80% of the thinnest Orbscan value and sewn with a 10x0 nylon suture in peribulbar anesthesia. In the Femto-group the Ziemer Z6 was used. The cut generated extended from 100µm below the epithelium to 60µm above Descemet's membrane. The operation was done in topical anesthesia both under direct microscopic visual control and screen-based electronic guidance. Keratometry, manifest refraction, BCVA and the difference of vector cylinders were analyzed.


In the trephine group keratometry showed no progression at 2, 3 and 4 years, respectively, in 93.4% (n=105 eyes), 81.8% (n=77 eyes) and 85.1% (n=47 eyes) of eyes. Manifest refraction did not progress in 89.6% (n=77 eyes), 86.2% (n=64 eyes) and 100% (n=29 eyes) of eyes. BCVA improved significantly from preoperative to 3 months and at all subsequent follow-up visits (p < 0.01). The vector differences were significantly reduced (p < 0.001). The Femto group comprised the period of 3 months to 1 year and showed quasi identical statistical figures.


CKT of both trephine and Femto group halt progression of early stage keratoconus. Advantages of using the Femto are speed of the operation and of postoperative course, sutureless, closed-eye and pain-free surgery.

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