Treatment Of Progressive Keratoconus : Fs-Laser Keratotomy

At present, the treatment of patients with progressive keratoconus remains an urgent task: UV-crosslinking and implantation of intrastromal corneal segments. In cases that do not meet the selection criteria and in advanced stages of progressive keratoconus, it is recommended to perform DALK or PK. In the absence of opacities in the central optical zone, it is possible to delay or avoid corneal transplantation. We have developed a new treatment method: FS-laser keratotomy combined with UV-crosslinking of corneal collagen.

S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation

Laboratory studies were carried out to develop a method, and operations were performed in the clinic.

The original software has been developed on Femto Visum and Femto LDV Z8, which allows for radial incisions to different depths, different numbers, frequencies, lengths, depending on the need. In this case, the optical zone remains 4 mm, and the length of the notches depends on the size of the patient's cornea. Radial keratotomy is performed, without deepithelialization, the notches are opened with filling the riboflavin and subsequent UV-crosslinking.

The observation period is more than 3 years. The data are stable, visual acuity is increased in the absence of corneal thinning and an increase in the refractive power of the cornea, which indicates stabilization of the keratectic process during our observation.

Our 3-year experience of FS-keratotomy combined with UV-krosslinking in the treatment of advanced keratoconus has proven the possibility of improving visual functions, stabilizing the keratectic process, and the safety of this type of surgical intervention. The proposed method makes it possible to avoid or delay keratoplasty even in advanced stages of keratoconus, when implantation of corneal segments is technically impossible. The problem requires further study.