Objective: To evaluate the clinical results and safety of deep anterior lamellar keratoplasty (DALK) in patients with keratoconus assisted by a femtosecond laser.
Methods: Six eyes of 5 patients with keratoconus underwent DALK procedures by using a femtosecond laser. The mean thinnest corneal thickness, evaluated with ultrasound and measurement of visual acuity by using the standard logarithm visual chart. A femtosecond laser was used to perform corneal cuts on both donor and recipient corneas. The data were expressed as mean ± SD. Mean follow-up was (8.9 ± 2.3) month (range, 5-12 months) .
Results: Corneal pachymetry was (385 ± 48) µm (range, 380-460 µm) . Mean preoperative uncorrected visual acuity was 0.06 ± 0.06 (range,0.01-0.15) and mean preoperative best spectacle-corrected visual acuity was 0.41 ± 0.35 (range,0.12-1.00) . The donor corneal lamella diameters were 0.20 mm larger and thicker than the recipient to restore a physiologic corneal thickness and shape. Mean donor diameter was (7.8 ± 0.2) mm (range, 7.3-8.0 mm) and mean thickness was (372 ± 40) µm (range, 350-400 µm) .Early postoperative evaluation showed a clear graft in all cases. Mean corneal thickness was (459 ± 36) µm (range, 389-488 µm) . At the last postoperative examination mean uncorrected visual acuity was 0.32 ± 0.19 (range, 0.12-0.60) , and the mean best corrected visual acuity was 0.58 ± 0.29 (range,0.20-1.00) . The UCVA and BCVA improved significantly after surgery (t = -4.433, -3.348, P < 0.05).
Conclusions: Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty shows promise as a safe and effective surgical choice in the treatment of keratoconus.