PT  - JOURNAL ARTICLE
AU  - Ronald N Gaster
AU  - Oanna Dumitrascu
AU  - Yaron S Rabinowitz
TI  - Penetrating keratoplasty using femtosecond laser-enabled keratoplasty with zig-zag incisions versus a mechanical trephine in patients with keratoconus
AID  - 10.1136/bjophthalmol-2012-301662
DP  - 2012 Jan 01
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2012-301662
4099  - http://bjo.bmj.com/content/early/2012/07/10/bjophthalmol-2012-301662.short
4100  - http://bjo.bmj.com/content/early/2012/07/10/bjophthalmol-2012-301662.full
AB  - 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.