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Comparison of Long-Term Outcomes of Femtosecond Laser-Assisted Keratoplasty with Conventional Keratoplasty
- Source :
- Cornea. 35(3)
- Publication Year :
- 2016
-
Abstract
- Astigmatism is a significant problem in penetrating keratoplasty. Lower astigmatism and better visual outcomes had been expected from laser-assisted penetrating keratoplasty, that is, from the top-hat, mushroom, or zig-zag cutting profiles. We report the long-term outcomes of 141 femtosecond laser-assisted penetrating keratoplasties retrospectively. We compare these outcomes with those of penetrating keratoplasty using the guided trephine system (GTS).In all, 141 femtosecond laser-assisted penetrating keratoplasties had been performed in 119 patients. The results were compared with those of conventional keratoplasty (n = 1254; visual and refractive outcomes, graft rejections, and graft failure).Follow-up averaged 33 months. In eyes with keratoconus, the time to achieve a visual acuity of 10/20 (Snellen) was shorter in the mushroom than in the GTS group. However, there was no relevant long-term difference. Graft astigmatism was higher in the laser groups [keratometric astigmatism at the end of follow-up: -4.5 ± 4 (GTS), -5.8 ± 3.3 (top-hat), -5.9 ± 3.2 D (mushroom); P0.01]. In eyes with keratoconus, rates of graft rejection were highest in the mushroom group (55%). In the other groups, top-hat keratoplasty resulted in lower rates of rejection than GTS keratoplasty (31%).There is no significant difference in the refractive and visual outcomes after femtosecond laser-assisted penetrating keratoplasty compared with GTS keratoplasty. The benefits from the use of the femtosecond laser may be limited and should be weighed against an increased risk of immune reactions, higher surgical complexity, and higher costs.
- Subjects :
- Adult
Male
Keratoconus
Visual acuity
Visual Acuity
Astigmatism
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Laser therapy
Long term outcomes
Medicine
Humans
Keratoplasty penetrating
Retrospective Studies
business.industry
Fuchs' Endothelial Dystrophy
Graft Survival
Suture Techniques
Corneal Endothelial Cell Loss
Middle Aged
medicine.disease
Laser assisted
Ophthalmology
Femtosecond
030221 ophthalmology & optometry
Optometry
Female
Laser Therapy
medicine.symptom
business
030217 neurology & neurosurgery
Keratoplasty, Penetrating
Subjects
Details
- ISSN :
- 15364798
- Volume :
- 35
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Cornea
- Accession number :
- edsair.doi.dedup.....eb0d2a24a6a81bb852edfe87b98a743c