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Outcomes of femtosecond-assisted mushroom keratoplasty

Poster Details

First Author: S.Madi EGYPT

Co Author(s):    J. Beltz   M. El-Anwar                 

Abstract Details

Purpose:

To report the visual outcomes and graft survival of mushroom shaped keratoplasty using femtosecond laser for the treatment of full thickness cornea opacities and healthy endothelium.

Setting:

Icare hospital affiliated with Alexandria university

Methods:

Retrospective chart review of 23 eyes of 23 patients (herpetic scar, n=10; keratoconus, n=7; bacterial scar, n= 3; traumatic scar, n=2 and failed graft, n=1) undergoing femtosecond-assisted mushroom shaped keratoplasty at Icare private hospital using the wavelight FS200 laser platform. The mushroom shaped graft consisted of a large top hat (9 mm in diameter and 230 microns in thickness) and a small stalk (6-6.5 mm). The donor was oversized by 0.2 mm. Outcome measures were best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, endothelial cell density, graft rejection, and graft failure at 1,3,6 and 12 months.

Results:

Average follow-up was 9 months (range 6�â�€�“15). All grafts were clear at the last follow up visit. Excluding eyes with pre-existing ocular co-morbidities, the percentage of patients achieving BSCVA of 20/40 or better at 1,3,6 and 12 months was 66.7%, 90.5%, 95.2% and 100%, respectively. At last follow up, the refractive cylinder was less than 6 Diopters (D) all eyes (mean=3.7 D). Mean endothelial cell loss at 3,6 and 12 months was 18.8%, 20.1% and 21.1%, respectively. Complications included 6 cases (26.1%) with incomplete cut requiring manual hand refinement and 2 endothelial rejections (8.7%) that resolved with topical steroids.

Conclusions:

Femtosecond-assisted mushroom keratoplasty shows faster visual recovery, better visual acuity and limited postoperative astigmatism with no increase risk of rejection when compared to conventional penetrating keratoplasty .

Financial Disclosure:

NONE

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