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Femtosecond laser pterygium surgery

Poster Details

First Author: J.Mehta SINGAPORE

Co Author(s):    M. Fuest   Y. Liu   M. Coroneo              

Abstract Details

Purpose:

Pterygium is a common ocular surface disorder. Conjunctival autografting (CAG) following pterygium resection is the gold standard. However, recurrence rates vary depending on surgeon experience. Thinner CAGs provide better results but are more technically demanding to achieve. In this study, we evaluated the feasibility and reproducibility of Femtosecond laser-assisted CAG preparation.

Setting:

Singapore National Eye Centre

Methods:

Fifteen porcine globes were fixed in a suction holder and 10 ellipsoid CAGs, of different diameters, were created by; (i) an experienced consultant, (ii) a less experienced fellow using the Ziemer LDV Z8. The CAG�Â�´s length and width was measured and the CAG thickness analysed by optical coherence tomography (OCT) and histology (HE). Statistical analysis was performed by Mann-Whitney U, Wilcoxon and Spearman test. A Clinical Trial was hence initiated to evaluate the performance in patients.

Results:

OCT measurements of CAGs at 100�Â�µm showed significantly higher deviation from desired depth (p=0.04) and a higher variability (p=0.03) in thickness than 60�Â�µm. Experienced and inexperienced surgeon produced 60�Â�µm grafts of comparable thickness (p=0.6) and variability (p=0.7). The CAG area measured after dissection did not significantly differ from the FS settings p=0.3. 5 patients underwent FLAPS surgery. Central and peripheral CAG thickness did not differ significantly (p=0.3). No buttonholes or tags occurred. The mean dissection time was 19.5 seconds, the time to remove the CAG was 10.3 �Â�±3.8 seconds. During follow-up no postoperative complication or recurrences occurred.

Conclusions:

FLAPS is a new technique, in which the preparation of an ultra-thin CAG is done by FSL.The FS allowed the accurate and reliable preparation of very thin (60�Â�µm) CAGs, independent of surgeon experience and may represent a valuable tool in pterygium surgery. Following optimization in porcine eyes, the clinical trial in the first 6 eyes was performed without any complications and the FSL might assist in further standardizing the surgical procedure. Longer follow-ups and larger cohorts are needed to assess recurrence rates.

Financial Disclosure:

NONE

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