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Femtosecond laser-assisted refractive autokeratoplasty in advanced keratoconus

Poster Details

First Author: H.Sitnik BELARUS

Co Author(s):    Y. Slonimsky   A. Slonimsky   T. Imshenetskaya              

Abstract Details


Development of a new method of autokeratoplasty with the use of femtosecond laser in patients with advanced keratoconus and evaluation of the results of treatment.


Belarusian Medical Academy of Post-Graduate Education, Minsk, Belarus Russian Medical Academy of Post-Graduate Education, Moscow, Russia State Budget Institution of Health 'City Clinical Hospital Botkin Moscow', Ophthalmic Hospital, Moscow, Russia


32 patients with advanced keratoconus were included in the study, mean age 31.8 �Â�± 9.9 UCVA before operation was 0.07 �Â�± 0.02 Minimal corneal thickness was 380 �Â�± 31.82 �Â�µ�Ð�¼, Ks 60.1�Â�±5.7 D, Kf 54.8 �Â�± 5.8 D, cylinder 8.7 �Â�± 3.6 D. Femtolaser-assisted refractive autokeratoplasty (FRAK) was performed with the use of �Â�«IntraLase 60 kHz�Â�». 1st circular corneal cut was fulfilled at an angle 90�Â�° to the surface. Cut diameter varied 8.0 to 8.4 mm. Second cut was performed at a predict depth and the circular corneal flap with wedge-shaped profile was formed. After flap removal wound was sutured.


Follow-up varied from 6 to 24 months. Significant improvement both UCVA and BCVA was observed. 90.6% of patients showed improvement UCVA. In 84.4% of cases the increase was more than 2 lines. In 37.5% (6 of 12 eyes undergone crosslinking after FRAK ) the increase of UCVA varied from 3 to 5 lines. Mean UCVA changed from 0.07 to 0.35, BCVA increased from 0.13 to 0.9 (�Ñ�€<0.05). Ks decreased to 55.2 �Â�± 2.6 D, Kf became 48.3 �Â�± 2.8 D, the cylindrical component decreased to 4.7 �Â�± 2.69 D. Endothelial cell density was stable with mean value 2650 c/mm2.


FRAK is a new effective method of treatment of stable advanced keratoconus. The advantages of this technique are following: the use and improvement of optical capacity of patient�â�€�™s cornea, improvement both UCVA and BCVA; non-penetrating nature of the operation helps to minimize the risks of surgical treatment; this method leaves the potential for corneal transplantation. Corneal crosslinking 6-8 months after FRAK stabilized the new corneal shape and improved visual acuity

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