Double-docking femtosecond anterior lamellar keratoplasty short term results
First Author: T.Morais Sarmento PORTUGAL
Co Author(s): A. Limão
To report the comparative results of double-docking femtosecond anterior lamellar keratoplasty (DD-FALK).
Instituto de Microcirurgia Ocular, Lisboa, Portugal
Retrospective comparative, nonrandomized case series involving patients who underwent DD-FALK with Z8 femtosecond laser (Z8, ZiemerTM) or classical deep anterior lamellar keratoplasty (Man-DALK), performed with mechanical trephines. All patients were examined preoperatively and were followed until at least 3 months postoperative. We analyzed best-corrected visual acuity (BCVA), keratometry, astigmatism, pachymetry values and conversion to penetrating procedures rates (unsuccessful rates). 16 eyes were submitted to DD-FALK while 14 eyes were submitted to Man-DALK. Demographic characteristics differences were not statistically significant between subgroups (p>0.05). The pathologies treated were keratoconus and corneal macula.
Mean age in DD-FALK was 30.25±11.25 and in Man-DALK subgroup was 34.23±8.79. Mean pre-operative BCVA was 0.22±0.17 in DD-FALK and 0.36±0.23 in Man-DALK (p>0.05). Pre-operative keratometry, pachymetry and astigmatism mean values were similar (p>0.05). At 3-month follow-up, mean post-operative BCVA increased 0.43±0.26 in DD-FALK and 0.32±0.31 in Man-DALK subgroup (p>0.05). Astigmatism changed +0.93±4.89 in DD-FALK and -0.3±8.66D in Man-DALK subgroup. Pachimetry values increased +174.81±114.25 in DD-FALK and +120.93±99.89 mcm in Man-DALK. Conversion to penetrating procedures rates were 37.5% in DD-FALK and 50% in Man-DALK subgroups with a 25% decrease in conversion rates in DD-FALK procedures, although not statistically significant (p>0.05).
This case series shows that DD-FALK constitutes a very interesting and non-inferior surgical option to offer increase in BCVA in anterior corneal pathologies on short term follow-up.