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Improved corrected distance visual acuity reported in study of femto-assisted DALK
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SAN FRANCISCO — Benefits of femtosecond laser-assisted keratoplasty, particularly for deep anterior lamellar keratoplasty, include improved corrected distance visual acuity, a decrease in the complication rate, more precise placement of the air needle, and ease of conversion to full-thickness penetrating keratoplasty if Descemet’s membrane is perforated, according to a speaker.
Reporting early outcomes of results of femtosecond laser-assisted DALK in 31 eyes, Ijeoma M. Asota, MD, said at the American Society of Cataract and Refractive Surgery meeting, "We did notice an early and steady improvement in corrected distance visual acuity."
Most patients started at 20/150 and improved to 20/30 or 20/40 at 1 year, she said. At 6 months, 75% of patients were better than 20/40, and at 1 year that percentage was 80% Asota said.
The technique involved using a femtosecond laser to create a nonpenetrating zigzag incision down to about 70 µm, performing lamellar dissection of host stroma, baring Descemet’s membrane using a big bubble technique, excising the remaining posterior stroma, removing donor endothelial cells and suturing the donor to the host.
Regarding time to suture removal, at 6 months, one-third of patients are out of all their sutures, and at 1 year, this percentage increases to more than half, she said.
"However, in our practice we don’t necessarily remove all sutures," she said, especially when the patient is stable with good corrected distance visual acuity.
Disclosure: Asota has no relevant financial disclosures, although some coauthors of the study are consultants for AMO.