Original articleComparison of Penetrating Keratoplasty Performed with a Femtosecond Laser Zig-Zag Incision versus Conventional Blade Trephination
Section snippets
Methods
Results are reported for consecutive cases of PK performed using the IntraLase femtosecond laser (Abbott Medical Optics, Santa Ana, CA) to make zig-zag pattern donor and host corneal incisions and compared with contemporaneous consecutive cases of conventional PK performed with conventional suction blade trephination, with the limitation that all cases were closed with a single, 24-bite running 10-0 nylon suture technique in both groups. The surgeries were all performed at the University of
Results
Table 1 summarizes the demographic and diagnosis information for the zig-zag group and the conventional group. A 24-bite, 10-0 nylon, running suture technique was used for all cases. Length of follow-up was 12 months for 18 eyes (nZZ = 13; ncon = 5), 9 months for 9 eyes (nZZ = 5; ncon = 4), 6 months for 14 eyes (nZZ = 9; ncon = 5), 3 months for 13 eyes (nZZ = 10; ncon = 3), and 1 month for 12 eyes (nZZ = 12; ncon = 0). The 2 groups were similar in age (rangeZZ, 19–98 years; rangeconv, 40–76
Discussion
In this retrospective case series, the femtosecond-generated zig-zag incision PK demonstrated faster recovery of BSCVA and less induced astigmatism than conventional blade trephination PK. Although our contemporaneous comparison group was small and not randomized, the level and speed of recovery of BSCVA that we saw in the zig-zag group exceed most previously reported visual acuity results with conventional PK. In this series, >75% of eyes with normal macular potential achieved ≥20/40 driving
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2021, Experimental Eye ResearchCitation Excerpt :FLAK incisions have shown a better fit between donor and host, fast and improved wound healing, and less suture induced astigmatism (Farid and Steinert, 2010). Early report on results of FS laser generated ‘zig-zag’ shaped incision compared with conventional Barron trephination for PKP had shown a more rapid recovery, improved best spectacle corrected visual acuity (BSCVA), and less induced surgical astigmatism in the FLAK group in the early post-operative period(Farid et al., 2009). A later report showed FLAK had significant improvement in astigmatism before but not after the 6-month follow up visit and there was no significant improvement in BSCVA at any time point during 24-month follow up (Chamberlain et al., 2011).
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2018, Advances in Ophthalmology and OptometryCitation Excerpt :This implies that the zig-zag edge shape provides the best wound healing rate and optical outcome among the aforementioned edge cut shapes for PKP [33]. Other studies have shown a faster recovery of best-corrected visual acuity and less induced astigmatism associated with zig-zag configuration compared with conventional keratoplasty, although it is unknown if these benefits are long term [27,34,35]. Finally, zig-zag configuration also has the simplest learning curve for suturing: its graft lamellar tissue apex and the corresponding host lamellar space are easily visualized, through which the suture can be passed.
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Manuscript no. 2008-1129.
Abbott Medical Optics provided supplies and equipment in support of the procedures.
Financial Disclosure(s): The authors have made the following disclosures: Roger F. Steinert - Consultant - Abbott Medical Optics (no financial interest in the femtosecond laser or the techniques in this investigation)