Investigation of femtosecond laser--enabled keratoplasty wound geometry using optical coherence tomography

Cornea. 2011 Aug;30(8):889-94. doi: 10.1097/ICO.0b013e3182041fd3.

Abstract

Purpose: To measure the wound geometry after femtosecond laser-enabled keratoplasty (FLEK) using optical coherence tomography (OCT).

Design: Prospective nonrandomized clinical study and laboratory study.

Participants: Patients who were candidates for penetrating keratoplasty at an academic referral center.

Methods: Wound architecture was measured and analyzed by OCT in 8 eyes of 8 consecutive patients who underwent FLEK. Femtosecond laser lamellar cuts were performed on 3 eye bank corneas, and the wound diameters were measured by OCT.

Results: Sutures were completely removed on average at 1 month per decade of age after surgery. No cases of wound dehiscence were noted, and graft-host tissue apposition appeared excellent on OCT. The mean spectacle-corrected visual acuity 1 month after suture removal was 20/35, and mean astigmatism was 5.0 diopters by manifest refraction and 8.7 diopters by computerized topography. The measured graft diameter was smaller than the laser setting by 2.5% (P = 0.007). The cut diameters of the eye bank corneas were also slightly smaller than the laser setting.

Conclusions: FLEK offers benefits of rapid wound healing and predictable wound geometry. The measured wound geometry agreed well with laser setting other than a small systematic deviation that could be explained by the mechanics of corneal applanation during the laser cut. OCT is a useful tool to measure the actual graft diameter after FLEK.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Corneal Topography
  • Female
  • Fourier Analysis
  • Humans
  • Keratoplasty, Penetrating / methods*
  • Laser Therapy / methods*
  • Male
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Suture Techniques
  • Tissue Adhesions
  • Tomography, Optical Coherence*
  • Visual Acuity / physiology
  • Wound Healing / physiology*
  • Young Adult