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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

Purpose:

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.

Setting:

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

Methods:

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.

Results:

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.

Conclusions:

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

Financial Disclosure:

NONE

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