April 24, 2013
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Femtosecond PK with zigzag incision yields stable visual recovery

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SAN FRANCISCO — Early suture removal after penetrating keratoplasty with a femtosecond laser-generated zigzag incision afforded stable visual recovery and minimal astigmatism, a speaker said here.

Perspective from Marianne O. Price, PhD

"Conventional corneal transplantation has been around for quite some time, and while it is a very good procedure, it does have some limitations, such as long recovery, suture-in-and-out astigmatism and poor corrected distance visual acuity," Matthew Wade, MD, said at the American Society of Cataract and Refractive Surgery meeting.

Matthew Wade, MD

Matthew Wade

"The zigzag femtosecond laser-enabled keratoplasty does have some theoretical advantages, including better initial incision integrity, which allows us to avoid excess suture tightness and decrease postoperative astigmatism, more wound surface area, allowing faster and stronger wound healing and faster visual recovery. Better anterior surface alignment theoretically improved visual acuity and astigmatism," he said.

The retrospective study included 83 patients with good visual potential who underwent femtosecond laser-enabled keratoplasty and had sutures removed an average of 1.2 years after surgery. Data were collected 6 months to 5 years after surgery.

Study results showed that logMAR uncorrected distance visual acuity improved from 0.74 preoperatively to 0.68 postoperatively. LogMAR corrected distance visual acuity improved from 0.28 preoperatively to 0.23 postoperatively. The gain in corrected distance visual acuity was statistically significant (P = .024).

Visual acuity results were similar in patients who had early suture removal and those who had sutures removed later. However, astigmatism was slightly greater in patients who had early suture removal, Wade said.

Disclosure: Wade has no relevant financial disclosures.