Lamellar keratoplasty ‘clean, fast’ with IntraLase

WASHINGTON — Lamellar keratoplasty using a femtosecond laser can be a viable alternative to penetrating keratoplasty in appropriate candidates, according to a surgeon speaking here.

The IntraLase FS laser allows creation of both donor and recipient anterior corneal lamellae in a “clean, fast, repeatable” 35-minute procedure that has resulted in visual improvement in most eyes, according to Ramòn Naranjo-Tackman, MD.

Dr. Naranjo-Tackman discussed his prospective evaluation of the procedure in 16 eyes of 16 contact-lens-intolerant patients here at the American Society of Cataract and Refractive Surgery meeting.

He said the preoperative uncorrected visual acuity in the eyes in the study was 20/200 or worse. Postoperatively, UCVA in 75% of eyes improved by at least 2 lines of acuity, and in 50% of eyes it improved by “up to 4 lines,” he said. The 8.5-mm grafts were clear in all eyes at 3 months postop.

Dr. Naranjo-Tackman said he used eight interrupted sutures combined with an eight-point running suture in all eyes. He said more study may be needed to determine the best time for suture removal, but it probably should not be done before 6 months postop.

Among the advantages of the lamellar procedure is the preservation of the recipient’s corneal endothelium, he said.