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Excimer laser-guided PK better than manual or femtosecond methods, surgeon says
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ROME — Excimer laser-guided penetrating keratoplasty is the most accurate and reproducible way of doing transplantation, according to a surgeon here.
Excimer laser-guided PK is better than manual trephination and femtosecond-guided methods, Berthold Seitz, MD, of Saarland University Hospital, Germany, said at the European Society of Cataract and Refractive Surgeons winter meeting.
Compared with manual methods, a laser-guided approach has the advantages of being non-contact and more precise, thus producing a significantly lower amount of astigmatism, he said.
Femtosecond laser application to PK is "the excitement of today," but there is a lack of comparative studies with long-term data to confirm the safety and efficacy of this method, according to Dr. Seitz.
Moreover, while excimer laser is a non-contact method and results in no mechanical deformation, with the femtosecond laser, "there is the contact and there is applanation," he said.
Non-mechanical trephination with the excimer laser has been used since 1989 by Dr. Seitz and colleague Gottfried Naumann, MD, so therefore they can rely on "20 years of good results, in a total of approximately 3,000 patients."
A prospective study has shown better outcomes with this technique compared with manual trephination, and in the future, new studies should be done to compare it with the femtosecond technique.
As far as the technical aspects of this procedure are concerned, Dr. Seitz said it is important to make the donor graft orientation as precise as possible into the recipient bed, using a special technique in which "orientation teeth" in the donor graft are made to coincide with notches of the same shape and size in the recipient stroma.