FemtoLASIK After Descemet Membrane Endothelial Keratoplasty

Cornea. 2020 Apr;39(4):468-472. doi: 10.1097/ICO.0000000000002193.

Abstract

Purpose: To evaluate the efficacy and safety of femtosecond laser-assisted in situ keratomileusis (FemtoLASIK) to correct the residual refractive error after Descemet membrane endothelial keratoplasty (DMEK).

Methods: This case series study included 7 eyes that underwent FemtoLASIK after a DMEK surgery. The refractive error, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, corneal topography (Sirius, CSO, Italy), and anterior segment optical coherence tomography (Visante, Carl Zeiss-Meditec AG, Jena, Germany) were registered at each postoperative follow-up visit.

Results: All surgeries were uneventful, with no intraoperative or postoperative complications. The follow-up time after DMEK (before FemtoLASIK surgery) ranged from 18 to 36 months. The post-FemtoLASIK follow-up period ranged from 12 to 60 months. All cases experienced a significant improvement in UDVA after FemtoLASIK, all of them reaching a postoperative UDVA value ≥20/32. None of the eyes lost lines of CDVA, and 1 case showed a gain of lines of CDVA. In all cases, the refractive error, UDVA, and CDVA values remained stable at their respective postoperative follow-up visits. Furthermore, all topographic and pachymetric parameters were stable at the different postoperative follow-up visits.

Conclusions: Our findings suggest that the residual refractive error after DMEK surgery can be safely and effectively treated with FemtoLASIK.

MeSH terms

  • Aged
  • Corneal Topography / methods
  • Descemet Stripping Endothelial Keratoplasty / methods*
  • Female
  • Follow-Up Studies
  • Fuchs' Endothelial Dystrophy / diagnosis
  • Fuchs' Endothelial Dystrophy / surgery*
  • Humans
  • Keratomileusis, Laser In Situ / methods*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / surgery*
  • Refraction, Ocular / physiology*
  • Refractive Errors / etiology
  • Refractive Errors / physiopathology
  • Refractive Errors / therapy*
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Visual Acuity*