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Femtosecond laser-assisted deep anterior lamellar keratoplasty (FALKe): the Linz-Hybrid technique

Poster Details

First Author: M.Dirisamer AUSTRIA

Co Author(s):    N. Luft   T. Kreutzer   S. Priglinger              

Abstract Details


Evaluation of the first clinical results of a new technique for deep anterior lamellar keratoplasty 
assisted by a femtosecond laser platform.


Non-randomized, prospective study, at a tertiary referral center. Department of Ophthalmology, Medical Faculty of the Johannes-Kepler University, Linz, Austria


This new technique combines the advantages of other techniques for deep anterior lamellar 
keratoplasty. As a first step a circular or a circular and lamellar cut to about 4/5 of stromal 
depth is made with the femtosecond laser (Visumax, Zeiss, Jena, Germany). The technique previously described by Melles et al. was used to reach pre-descemet level with the needle under optical control, followed by air injection to get a so called ‚Big bubble’.


All femtosecond laser procedures were uneventful without any complications. Successful ‚big bubbles’ could be obtained in 12 out of 20 cases (60%). Due to a large perforation of 
Descemet membrane in 2 cases despite a successful ‚Big bubble’ 10 procedures in total had to be 
converted into perforating keratoplasty. 
Six months postoperatively 74% of the patients reached a best spectacle corrected visual 
acuity (BSCVA) of 20/40 or higher, 47% reached a best spectacle corrected visual acuity of 
20/25 or higher and 13% oft the patients achieved an BSCVA of 20/20 or higher respectively. 


Despite the learning curve of this new femtosecondlaser assisted technique for deep anterior lamellar keratoplasty 
 (FALKe), the first clinical results are promising. Common difficulties in deep anterior 
lamellar keratoplasty could be reduced with combining advantages of different techniques and technologies.

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