ESCRS - FP11.15 - Keratoprosthetics Technology With Femtosecond Laser Assistance

Keratoprosthetics Technology With Femtosecond Laser Assistance

Published 2025 - 43rd Congress of the ESCRS

Reference: FP11.15 | Type: Free paper | DOI: 10.82333/4bxx-6a66

Authors: Nilufer Yesilirmak* 1 , Yonca A. Akova 2 , Umut Akova 3 , Dondu Melek Ulusoy 4

1Ophthalmology,Ankara Yildirim Beyazit University,Ankara,Türkiye;Ophthalmology,Ankara Bilkent City Hospital,Ankara,Türkiye, 2Ophthalmology,Bayindir Kavaklidere Hospital,Ankara,Türkiye, 3Emory University School of Medicine,Atlanta,United States, 4Ophthalmology,Ankara Bilkent City Hospital,Ankara,Türkiye

Purpose

To access the possibility of using a femtosecond laser to form an intrastromal pocket in the patient’s opaque cornea for keratoprosthetics operation.

Setting

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

Methods

The study included 10 patients who have a single eye after chemical burn or due to multiple unsuccessful keratoplasties. In all cases, patients were not indicated for optical keratoplasty or stem cell transplantation. The cornea was opaque in all cases, but had a relatively uniform thickness with no signs of thinning (more than 650 μm). To form an intrastromal pocket in the patients' own cornea, a femtosecond low-energy laser Femto LDV Z8 (Ziemer Ophthalmic Systems, Switzerland) was used. A keratoprosthesis supporting plate (KSP) of Fyodorov-Zuev keratoprosthesis was implanted into the formed intrastromal pocket inside cornea.

Results

Thanks to the built-in OCT, using increased level of energy, the femtosecond laser allows to form a pocket for the KSP precisely, with the required depth, width, and length, and to avoid a penetrating trepanation of the cornea for transplantation of the corneal-prosthetic complex. The minimal tissue bridges were easily cut by the surgeon manually and did not prevent an implantation of KSP into the pocket. The stable position of the KSP in the cornea after 6 months helps to reduce the risk of protrusion and to install the optical cylinder. After 12 months of observation all patients achieve the increase of visual acuity.

Conclusions

According to our observations, the femtosecond laser facilitates the formation of an intrastromal pocket even inside not transparent vascularized cornea, reduces the risk of corneal perforation and reduces the total operating time during the formation of an intrastromal pocket, in contrast to the traditional manual method using microsurgical instruments.