Abstract
OBJECTIVE: To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK).
METHODS: We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK. Corneal thickness was measured using an optical coherence tomography technique.
RESULTS: The average BSCVA of 11 eyes with normal visual potential significantly improved from 20/110 +/- 4 lines to 20/57 +/- 1 line at 6 months (P < .007). At 6 months, the mean (SD) hyperopic shift was 2.24 (2.3) diopters (D). Preoperative and 6 months postoperative refractive astigmatism were -0.75 (0.9) D and -1.58 (1.1) D (P = .01), but the topographic astigmatism did not change postoperatively (P = .95). Mean (SD) endothelial cell density at 6 months was 1368 (425) cells/mm(2). There was a persistent deswelling of the graft up to 3 months postoperatively. Complications included graft dislocations requiring repositioning (20%), pupillary block glaucoma (5%), epithelial ingrowth (5%), and primary graft failure (5%).
CONCLUSIONS: Femtosecond laser-assisted Descemet stripping endothelial keratoplasty was effective in treating endothelial failure with minimal induced refractive astigmatism, limited improvement of BSCVA, and induction of a hyperopic shift. Endothelial cell count and dislocation rate were significant, which may be related to the surgical technique.
Original language | English |
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Pages (from-to) | 1351-6 |
Number of pages | 6 |
Journal | Archives of Ophthalmology |
Volume | 126 |
Issue number | 10 |
DOIs | |
Publication status | Published - Oct 2008 |
Keywords
- Aged
- Corneal Diseases/diagnosis
- Corneal Surgery, Laser/methods
- Corneal Transplantation/methods
- Descemet Membrane/surgery
- Endothelium, Corneal/surgery
- Evaluation Studies as Topic
- Female
- Follow-Up Studies
- Fuchs' Endothelial Dystrophy/diagnosis
- Graft Rejection
- Graft Survival
- Humans
- Male
- Middle Aged
- Probability
- Prospective Studies
- Risk Assessment
- Statistics, Nonparametric
- Treatment Outcome
- Visual Acuity