Uneven Corneal Epithelial Redistribution After Femtosecond Laser-Assisted Lenticule Intrastromal Keratoplasty In Correcting Moderate-To-High Hyperopia

Published 2024 - 42nd Congress of the ESCRS

Reference: PO1160 | Type: Poster | DOI: 10.82333/0hk3-b052

Authors: Jiawei Wu* ¹ , Zheng Wang ¹

¹Refractive Surgery Center,Aier eye hospital,Guangzhou ,China

Purpose

This study aimed to evaluate the characteristic of corrective epithelial thickness after femtosecond laser-assisted lenticule intrastromal keratoplasty (LIKE) procedure to correct moderate-to-high hyperopia.

Setting

This prospective, consecutive case series study was performed between 2018 and 2023.

Methods

The study of the LIKE procedure was performed to correct moderate-to-high hyperopia. A 110μm thick and 8.8mm diameter corneal flap was made with the femtosecond laser. The donored matched lenticule was placed on the stromal bed, rotated to the target axis according to the corneal mark. The lenticule was adequately dehydrated and the corneal flap was replaced. A bandage contact lens was placed at the end of the procedure. The epithelial thickness map was generated by anterior segment optical coherence tomography in the corneal central 9mm zone. Keratometry and corneal high-order aberrations were analyzed by Pentacam between pre- and post-operation. In the 26 eyes (13 participants) who underwent the LIKE for moderate-to-high hyperopia.

Results

The attempted spherical equivalence (SEQ) of the enrolled participants was +6.50±1.09 diopters (D). Compared to the preoperative epithelial thickness maps, the postoperative epithelial thickness has become significantly thinner in the central 5mm zone; the difference was about 6~7μm. The paracentral epithelium performed non-uniform remodeling; the thinnest epithelial thickness was located in the inferotemporal section, which has the greatest difference from the superonasal; the difference between these two was approximately 3μm. Through correlation analysis, it was found that the sections with thinner epithelium are significantly related to corneal curvature and corneal vertical coma.

Conclusions

LIKE procedure can be used to correct moderate-to-high hyperopia. This study further indicated the epithelial remodeling characteristic after the LIKE procedure: the central and paracentral corneal epithelial thickness becomes thinner, and the epithelial thickness distributes non-uniform, which may be the important factor of the postoperative curvature asymmetric distribution and induction of corneal vertical coma.