Mushroom-Shape Femtosecond Laser Assisted Dalk Guided By Real Time Anterior Segment Optical Coherence Tomography (As-Oct)
Published 2023 - 41st Congress of the ESCRS
Reference: PO0708 | DOI: 10.82333/8s0k-bg73
Authors: Mayte Ariño-Gutierrez* 1 , Jose Antonio Gegundez-Fernandez 1 , Pedro Arriola-Villalobos 1 , Barbara Burgos-Blasco 1 , Beatriz Vidal-Villegas 1 , Ricardo Cuiña 1 , Rosalia Mendez 1 , David Diaz-Valle 1 , Alberto Villarrubia-Cuadrado 2
1Cornea and Anterior Segment,Hospital Clinico San Carlos,Madrid,Spain, 2Cornea and Anterior Segment,Hospital La Arruzafa,cordoba,Spain
To describe the utility of femtosecond laser technology and real time anterior segment optical coherence tomography (OCT) while performing deep anterior lamellar keratoplasty (DALK) in a variety of corneal diseases.
Hospital Clínico San Carlos, Madrid
22 patients underwent a Mushroom shape predescemetic DALK assisted by femtosecond laser in a tertiary hospital. Patients’ diagnosis included: postinfectious scar, severe keratoconusiza, postLASIK ectasia and different corneal dystrophies. Different techniques were used to achieve a smooth and clear posterior stroma within the 6mm optical zone. BCVA, Keratometry, endothelial cell count and corneal densitometry were analyzed at months 6 and 12 postoperatively.
The femtosecond laser allows us to perform customized mushroom-shaped cut patterns in both corneas (donor and host) with a larger superficial diameter of 8.7 mm and a smaller deep area of 6.0 mm. A manual layer by layer dissection was performed in all cases to clear the posterior stroma within the 6mm optical zone. The intraoperative OCT guidance helps to improve the corneal layers’ visualization during the surgery. A predescemetic DALK was performed in all 17 cases with none conversion to Penetrating Keratoplasty (PK). A residual bed stromal thickness of less than 80 microns was obtained and eight 10/0 nylon single sutures were enough to obtain a very nice fitting between donor and host.
This mushroom pattern femtoDALK is a safe procedure helps to reduce the risk of macroperforation and subsequent conversion to penetrating keratoplasty with only 8 single sutures with good keratometric results.