Korean J Ophthalmol.  2008 Mar;22(1):43-48. 10.3341/kjo.2008.22.1.43.

Case Report: Femtosecond Laser-Assisted Small Incision Deep Lamellar Endothelial Keratoplasty

• Lee DH
• Chung TY
• Chung ES
• Azar DT

• KMID: 1107490
• DOI: http://doi.org/10.3341/kjo.2008.22.1.43

Abstract

PURPOSE: To report two cases of femtosecond laser-assisted small incision deep lamellar endothelial keratoplasty (DLEK) for patients with corneal endothelial decompensation by Fuchs dystrophy and glaucoma METHODS: Femtosecond laser (IntraLase(R); IntraLase Corp., Irvine, CA) with 15 kHz of repetition rate, was used for a 9.5 mm diameter by 400 micrometer thickness donor corneal lamellar dissection. RESULTS: In Case 1, the graft was clear and compact without interface haze, Orbscan showed smooth and regular corneal surface, specular microscopy was unremarkable without sign of corneal endothelial damage, and Optical coherence tomography showed uniform graft well attached to recipient stroma with minimal interface reflection at 2 months postoperation. In Case 2, the graft was clear and compact with minimal interface haze at 1 month postoperation. Femtosecond laser-assisted small incision DLEK was safe and technically feasible in our cases; however, further evaluation is required to determine long-term effects.

Keyword

Deep Lamellar Endothelial Keratoplasty; Femtosecond Laser

MeSH Terms

Aged
Aged, 80 and over
Corneal Edema/*surgery
Corneal Surgery, Laser/*methods
Corneal Topography
Corneal Transplantation/*methods
Endothelium, Corneal/*transplantation
Female
Fuchs' Endothelial Dystrophy/*surgery
Humans
Male
Tomography, Optical Coherence
Visual Acuity

Figure

• 

  Fig. 1 Preoperative photograph of a 73-year-old male showing corneal edema and guttata with beaten metal appearance (A). Specular microscopy shows coalesced guttata excrescences in the form of dark structures (cell density 1363 cell/mm2, coefficient of variation 0.44, hexagonality 54%) (B).

• 

  Fig. 2 Postoperative photograph of a 73-year-old male two months after femtosecond laser-assisted small incision DLEK surgery showing clear and compact graft without interface haze (A, Top left). Specular microscopy shows no endothelial cell damage after surgery (cell density 1962 cell/mm2, coefficient of variation 0.39, hexagonality 56%) (B, Top right). Orbscan shows smooth and regular corneal curvature (C, Bottom).

• 

  Fig. 3 Optical coherence tomography (OCT) of a 73-year-old male two months after femtosecond laser-assisted small incision DLEK surgery. Vertical (A) and horizontal (B) OCT of the cornea show compact and uniform graft which is well attached to recipient stroma with minimal interface reflection (Arrowheads).

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