Intraoperative Optical Coherence Tomography–Guided Femtosecond Laser–Assisted Deep Anterior Lamellar Keratoplasty

Purpose: To describe the feasibility and outcomes of intraoperative optical coherence tomography (OCT)–guided, femtosecond laser–assisted deep anterior lamellar keratoplasty in which the lamellar and tunnel cuts were completed by laser. Methods: The Ziemer Z8 system was used to scan the corneas intraoperatively and guide the stromal lamellar and tunnel cuts created by the laser. Thirty porcine eyes and 3 human cadaver globes were used to evaluate the accuracy of laser-created intrastromal tunnels and the feasibility of achieving big-bubble pneumatic dissection. The tunnel distance above the Descemet membrane (Dt-dm) was set at 100 and 130 μm, and the accuracy of laser cut was assessed by anterior segment OCT and histological sections. Fourteen patients with keratoconus or corneal scars were then included to evaluate the clinical outcomes. Results: The deviation from the targeted Dt-dm was 5.5% to 8.6% and 0.7% to 9.8% for the 100 and 130 μm groups, respectively. The achieved thickness had a significantly and positively strong correlation with the targeted thickness (r = 0.86; P
Source: Cornea - Category: Opthalmology Tags: Techniques Source Type: research