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Long-term results of femto-assisted deep anterior lamellar keratoplasty for keratoconus in two different rim patterns

Poster Details

First Author: R.Salouti IRAN

Co Author(s):    M. Nowroozzadeh   M. Zamani   M. Ghoreyshi   G. Melles           

Abstract Details


To report outcomes of femto-assisted deep anterior lamellar keratoplasty (femto-DALK) in a large series of patients with keratoconus in two rim patterns.


Shiraz University of Medical Sciences, Iran Postchi Research Eye Center, Iran Salouti Eye Clinic, Research Center, Iran


243 eyes from 243 patients who underwent Femto-assisted DALK using Melles technique with with TECHNOLAS perfect vision Femtosecond Workstation 520F (FEMTEC). 95 patients underwent Decagonal rim pattern and 145 eyes underwent Mushroom pattern. Main outcome measure were patients’ demographics, preoperative and postoperative best spectacle–corrected visual acuities (BSCVAs), Corneal Topography and tomography, Corneal and refraction astigmatism , Wavefront analysis (I-TRace) and corneal biomechanical (Corvis and ORA), and specular microscopy.


The mean age of participants was 28 years, and 135 were male. The rim shape was mushroom in 145 eyes, polygonal in 94, and round in 5. The logMAR BSCVA was improved from 0.65 before operation to 0.15 in mushroom and to 0.19 in polygonal at 6 months; 0.13 in mushroom and to 0.15 in polygonal at 24 months. The SE refraction was improved from -5.55D to -2.29D, mean keratometry from 55 D to 44.81D, keratometric astigmatism from 5.15D to 2.68D, and endothelial cell density from 2412 to 2630. There was no intra- or post-operative complications.


Femto-DALK was a successful method for improving BSCVA and restoring corneal anatomy in patients with keratoconus, with low rate of complications. The two Rim Patterns has relatively same properties in corneal topography and corneal biomechanics.

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