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Femtosecond laser zigzag incision may be more effective than manual technique in PK

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Marjan Farid

NEW ORLEANS — A femtosecond laser zigzag incision can offer faster wound healing and stronger wounds after penetrating keratoplasty when compared with manual incisions, according to a speaker here.

“Does femto really help? We know we get stronger wounds with these stepped incisions. We get faster wound healing and earlier suture removal, and there are probably some improved refractive outcomes. We’re also seeing more regularity of grafts,” Marjan Farid, MD, said at Cornea Subspecialty Day preceding the American Academy of Ophthalmology meeting.

Self-aligning laser incisions result in less required suture tension and less torsional and vertical misalignment, and have implications for more rapid visual recovery and less astigmatism, she said.

In the current results of a retrospective comparison conducted by Farid and colleagues, 335 eyes underwent femtosecond laser-enabled keratoplasty zigzag incisions or various suture patterns during penetrating keratoplasty. Patients who underwent the zigzag incisions experienced consistent levels of astigmatism for more than 7 years. Most eyes reached their corrected distance visual acuity by postoperative month 3 and maintained it throughout the study period, Farid said.

Farid also said uncorrected visual acuity, corrected distance visual acuity and cylinder were all stable even after the sutures were removed.

“The bottom line is we have to ask ourselves, if we were going to have a corneal transplant, what kind of an incision would we prefer, a femtosecond incision or a manual butt-joint wound incision? Really, I think femto is the future. Just like we have intraocular lenses that are meeting our refractive goals, this is where we’re going to meet the refractive goals of our corneal transplant patients,” Farid said. – by Robert Linnehan

Reference:

Farid M. Spicing up penetrating keratoplasty: Does femto really help? Presented at AAO Subspecialty Days; Nov. 10-11, 2017; New Orleans.

Disclosure: Farid reports she is a consultant with Abbott, Alcon Laboratories, Allergan and Shire.