Better results seen with femtosecond laser endothelial keratoplasty

BUENOS AIRES — Endothelial keratoplasty with a femtosecond laser offers less inflammation, faster visual improvement, better visual acuity and rapid visual rehabilitation, a surgeon said here. Using optical coherence tomography can show problems with gaps and misalignment, she added.

Luciene Barbosa de Sousa

At the Argentinean Society of Ophthalmology Annual Course, Luciene Barbosa de Sousa, MD, presented 6-month results of a prospective study of 60 patients, randomized to endothelial keratoplasty performed with either the IntraLase femtosecond laser (Advanced Medical Optics) or vacuum trephine. All surgeries were performed by the same surgeon using the same size receptor and donor with a combined suture.

At 6 months, Dr. Barbosa de Sousa said there was less inflammation in the femtosecond laser group. Four patients from the manual group experienced rejection, as did one from the femtosecond laser group.

Researchers used Visante OCT (Carl Zeiss Meditec) to evaluate the quality of incisions and sutures. There were no statistical differences between the groups, but they were able to show wound healing and misalignments.

In the femtosecond laser group, 93% of patients had a logMAR visual acuity better than 0.60; in the manual group, 53% were between 0.30 and 0.50 logMAR and 46.7% were better than 0.60 logMAR, Dr. Barbosa de Sousa said.

There were no significant differences in cylinder and spherical axis, she added.