PK performed with femtosecond laser-created zigzag incisions shows early efficacy, stability

Performing penetrating keratoplasty using a femtosecond laser to create surgical incisions in a zigzag pattern appears biomechanically stable, according to a study by researchers in California. Patients treated with the technique showed "excellent" wound apposition and integrity, and had only moderate astigmatism within a few months postop, the authors noted.

Marjan Farid, MD, and colleagues reviewed outcomes from full-thickness PK performed in 13 eyes of 13 patients. In all cases, the surgeon used the IntraLase FS femtosecond laser (Advanced Medical Optics) to create zigzag-patterned incisions in both the donor graft and the recipient cornea, according to the study.

These zigzag incisions were created in a consistent pattern, matching the donor and host, the authors noted.

Follow-up ranged from 3 to 9 months postoperatively.

The researchers found that astigmatism averaged 3 D or less at all follow-up points beginning at 1 month postop, with a maximum of 4.25 D of astigmatism seen from 3 months out to final follow-up.

Specifically, nine eyes (69%) had no more than 3 D of astigmatism and six eyes (46%) had no more than 2 D of astigmatism by 3 months follow-up, according to the study.

Among eight eyes with the potential for full vision, seven eyes (87.5%) had a best corrected visual acuity of 20/30 or better at 3 months, and one eye had improved to 20/25 at 6 months follow-up.

"Optical coherence tomography images showed excellent anterior and posterior wound alignment, including one eye where the running suture loosened and was fully removed before month 3," the authors reported.

The study is published in the December issue of Ophthalmology.