J Korean Ophthalmol Soc.  2008 Jan;49(1):40-47. 10.3341/jkos.2008.49.1.40.

Early Result of Femtosecond Laser Assisted Descemet's Membrane Stripping Endothelial Keratoplasty

• Seo WM
• Kim HK

• KMID: 2211181
• DOI: http://doi.org/10.3341/jkos.2008.49.1.40

Abstract

PURPOSE: To report the first cases of Descemet's stripping endothelial keratoplasty in patients with pseudophakic bullous keratopathy.
METHODS
Four eyes of 4 patients who had corneal edema from pseudophakic bullous keratopathy were enrolled. We performed femtosecond laser-assisted Descemet's membrane stripping endothelial keratoplasty (DSEK). We then evaluated preoperative and postoperative best corrected visual acuities (BCVA), manifest refractions, keratometries, topographic astigmatisms, corneal pachymetries, and perioperative complications.
RESULTS
The mean follow-up period was 6 months. Three of the four eyes had successful transplantations. Since the operation, these patients have shown improvement in visual acuity and have recovered from corneal edema. However, in one patient, the transplanted corneal disc was dislocated, and he needed an additional procedure for reattachment.
CONCLUSIONS
The lack of corneal incisions or sutures in DSEK was helpful for maintaining corneal curvature and globe integrity after surgery. The surgery resulted in rapid visual rehabilitation and prevented suture-induced complications. With a femtosecond laser, we could prepare donor cornea in an automated and standardized fashion. In conclusion, femtosecond laser-assisted DSEK has significant advantages over standard penetrating keratoplasty for patients with pseudophakic bullous keratopathy.

Keyword

Descemet's membrane stripping endothelial keratoplasty; Femtosecond laser

MeSH Terms

Cornea
Corneal Edema
Corneal Transplantation
Descemet Membrane
Eye
Follow-Up Studies
Humans
Keratoplasty, Penetrating
Sutures
Tissue Donors
Transplants
Visual Acuity

Figure

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  Figure 1. Each line represents the changes in best corrected visual acuity for a single patient.

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  Figure 2. Preoperative photo of patient 1 showing corneal edema and haze from pseudophakic bullous keratopathy. Intraocular lens haptic (arrow) is protruded through the previous iridectomy site.

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  Figure 3. Slitlamp photograph of DSEK graft 2 weeks after surgery. Note the clear central cornea with clear interface and smooth surface. The edge of the donor tissue is illuminated (arrow).

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  Figure 4. OCT shows smooth interface and regular thickness of the corneal graft (arrows).

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  Figure 5. Dislocated corneal disc is sutured with 10-0 nylon at 1,3 and 10 o’clock (arrow). Corneal edema is persisted at detached corneal disc (asterisk).

Reference

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