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Femtosecond laser-assisted top hat PK has good results
Br J Ophthalmol. 2009;93(1):73-78.
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Femtosecond laser-enabled top hat penetrating keratoplasty produced solid visual, refractive and anatomic outcomes compared with manual top hat penetrating keratoplasty and conventional penetrating keratoplasty.
The prospective, non-randomized study included 23 eyes that underwent femtosecond laser-enabled keratoplasty, 36 eyes that had manual top hat PK and 35 eyes that had conventional PK. A 60 kHz IntraLase femtosecond laser (Advanced Medical Optics) was used. Patients underwent follow-up examination at 1 day, 1 week, and 1, 3, 6 and 12 months after surgery.
At 12 months, mean logMAR best corrected visual acuity was 0.32 in the laser group, 0.53 in the manual top hat group and 0.39 in the conventional PK group. Mean spherical equivalent was less than –2.2 D and was similar in all three groups. Mean cylinder was 3.6 D in the laser group, 4.1 D in the conventional PK group and 5.1 D in the manual top hat group.
Mean time to suture removal was 4.1 months in the laser group, 3.9 months in the manual top hat group and 9.7 months in the conventional PK group.
Also at 12 months, endothelial cell loss was 40.8% in the conventional PK group, 32.4% in the laser group and 22.3% in the manual top hat PK group.