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Comparison of microkeratome-assisted vs femtosecond-assisted anterior lamellar therapeutic keratoplasty for disorders of the anterior part of the corneal stroma

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Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Sunday 08/10/2017 | 10:30-12:30

Paper Time: 10:30

Venue: Meeting Center Room I

First Author: : I.Guber SWITZERLAND

Co Author(s): :    C. Bergin   F. Majo   Z. Gatzioufas   S. Hamada   D. Lake        

Abstract Details


To compare the visual outcomes and complications of automated anterior lamellar therapeutic keratoplasty (ALTK) vs femtosecond-assisted (FALK) in children and adults, and to examine these outcomes as a function of age and etiology.


Consecutive series of cases undergoing automated ALTK procedures performed at the Jules-Gonin Eye Hospital, Switzerland, between and 6/2003 and 1/2015 and all consecutive cases of FALK performed at the Queen Victoria Hospital, East Grinstead, UK between and 11/2009 and 6/2016 Only patients with at least 3 months follow-up were included


There were 37 eyes (27 vs10 M/F, 12 vs 24 R/L) in the ALTK group with mean age of 47.3 ±16.3 years and 18 eyes (10 vs 8 M/F, 8 vs 10 R/L) in the FALK group with mean age of 48.9 ±19.1 year. Mean follow-up was 32(±26) months in the ALTK group and 35(±35) months in the FALK group.


Median visual acuity at last visit was 0.40 IQR 0.15 to 0.60 vs. 0.45 IQR 0.30 to 0.70 LogMAR (p=0.59), with a range of 100% to hand movements. Failure occurred in 6 (16%) vs. 0 (0%) of cases, the 6 cases of failure were due to infiltrates, haze, chronic ulcer, hypotony, folds in descemets membrane and irregular astigmatism. Complications were observed in 17 (46%) vs. 8 (44%) of cases, some eyes had multiple complications, 5 vs. 3 serious complications were observed and 17 vs. 24 minor complications.


This study shows that FALK is similar to ALTK in terms of visual outcomes and complication rates. Most cases need contact lens adaptation or extra surgery to improve final vision. However, most patient had visual benefit after the surgery.

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