Corneal Endothelial Cell Density (Ecd) And Refractive Outcomes After Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty (Dalk) For Corneal Stromal Pathology.

To examine endothelial cell (EC) loss, refractive and topographic astigmatism after Femtosecond laser-assisted DALK for corneal stromal pathology. 

Ophthalmology department Dnipro State Medical University, Dnipro regional Ophthalmology Hospital.

Exam of 56 eyes of 56 patients with a corneal stromal pathology not affecting the endothelium, respectively, between 2018 and 2023were performed. Corneal ECD was examined using specular microscopy at postoperative 1, 2, and 5 years. Visual acuity, corneal topography and optical coherence tomography findings were recorded. The DALK procedure was performed with femtosecond laser device without perforation of Descemet's membrane.

Five years after Femtosecond laser-assisted DALK performed without perforation of Descemet's membrane with a clear graft, EC loss was 23.6%. The highest percentage of EC loss was observed during first year. At 5 years postoperatively, refractive and topographic astigmatism in the DALK groups were -2.76 ± 1.3 diopters (range from 1.4 to 4.1 diopters). 

Femtosecond laser-assisted DALK is a high-precision procedure. Trephination of the recipient cornea is performed automatically and avoid of perforation of Descemet's membrane.With this technique of surgery EC loss was 23.6% over the five year period.