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Femtosecond laser-assisted DALK technique

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This video shows our personal way of performing deep anterior lamellar keratoplasty assisted by femtosecond laser. The laser produces regular, smooth cutting surfaces that facilitate the separation of the anterior stroma and enhance the adherence between recipient and donor.

We show here how the femtosecond laser is used for trephination of the donor graft, according to precisely personalized diameter and profile parameters.

In the recipient, we use the laser to obtain a deep stromal dissection plane, down to about two-thirds of corneal thickness at the thinnest point, and a stromal tunnel leading from that plane to the Descemet’s.

A cannula is inserted along this tunnel, and a big bubble is injected to separate the Descemet’s from the cornel stroma.

Finally, the donor graft is placed on the surface and sutured using nylon 10-0.

For more information:

Alessandro Galan, MD, an OSN Europe Edition Board Member, is head of ophthalmology at Sant’Antonio Hospital, Padua, Italy. He can be reached at Ospedale Sant’Antonio, Via Facciolati 71, Padova, Italy; email: alessandro.galan@gmail.com.