Femtosecond laser enhances keratoplasty

The femtosecond laser offers several clear advantages for lamellar and penetrating keratoplasty procedures, according to an Italian surgeon speaking at the 13th ESCRS Winter Meeting in Rome, Italy.

Opening the first session at the annual Cornea Day, Emilio Balestrazzi MD gave an overview of how the femtosecond laser is changing the face of lamellar and penetrating keratoplasty surgery.

“The IntraLase femtosecond laser (AMO) is a dynamic surgical tool which enables surgeons to perform valid, safe and repeatable lamellar and penetrating keratoplasty techniques. However, we must be cautious in the application of this exciting technology and remember that it is still a work in progress,” he said.

For femtosecond laser assisted deep anterior lamellar keratoplasty (femto-DALK) procedures, Dr Balestrazzi said that the goal is to utilise a surgical option that could be compared in results to manual DALK, preserving the health and integrity of the corneal endothelium.

Using this approach, a clear graft was achieved in all patients one week after surgery and confocal microscopy evaluation showed no significant differences in pre- and postoperative endothelial pattern and density. Two patients experienced a perforation during the IntraLase cut which required a subsequent penetrating keratoplasty.

Turning to femtosecond laser assisted penetrating keratoplasty, Dr Balestrazzi said that this technique is designed to create a simpler and repeatable surgical technique to generate less astigmatism, greater scar strength and faster visual recovery times.

In addition, any cut configuration and angulation can be chosen, the cut quality is excellent and the prepared donor transplant nestles perfectly in the recipient eye.