Penetrating keratoplasty using femtosecond laser-enabled keratoplasty with zig-zag incisions versus a mechanical trephine in patients with keratoconus
- Correspondence to Dr Yaron Rabinowitz, Cornea Eye Institute, Cedars Sinai, 50 N. La Cienega Blvd., Suite 340, Beverly Hills, CA 90211, USA;
Contributors All authors contributed to the writing, editing and data collection for this paper.
- Accepted 9 June 2012
- Published Online First 11 July 2012
Background/aims This paper will compare the visual outcomes of two different penetrating keratoplasty (PKP) techniques in patients with keratoconus. It is a retrospective comparative surgical case series of 116 keratoconus patients (137 eyes) who had PKP at the Cornea Eye Institute, Beverly Hills, California, USA.
Methods 56 keratoconus patients (66 eyes) underwent femtosecond laser-enabled keratoplasty (FLEK) with a zig-zag incision configuration. Their visual parameters were compared with those of 60 patients (71 eyes) who had traditional blade mechanical trephination PKP. The range of follow-up was between 3 and 6 months. The main outcome measures included uncorrected visual acuity and best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent and topographically determined astigmatism.
Results BSCVA was significantly better as early as 3 months postoperatively (p=0.001) in the FLEK group. Visual recovery to 20/40 after 3 months was significantly better in the FLEK group (p<0.001). Topographic astigmatism was lower in the FLEK group, but the difference between the two groups reached significance only at 3 months of follow-up (p=0.001). Postoperative complications noted were not different between the two groups.
Conclusions Faster visual recovery and better long-term outcomes were observed in keratoconus patients who had FLEK compared with those who had the mechanical PKP procedure with 6 months of postoperative follow-up.
Funding This work was supported by Eye Defects Research Foundation grant 005.
Competing interests None.
Ethics approval Ethics approval was provided by the ethics committee of the Eye Surgery Center of Beverly Hills.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.