Microkeratome-assisted vs femtosecond laser-assisted superficial anterior lamellar keratoplasty: A randomized controlled trial

Abstract

Purpose: The purpose is to compare the outcomes between microkeratome-assisted superficial anterior lamellar keratoplasty (MK-SALK) and femtosecond laser-assisted superficial anterior lamellar keratoplasty (FL-SALK) for superficial corneal opacities. Methods: Seventy-five eyes with superficial corneal opacities were prospectively randomized into the MK-SALK control arm and an FL-SALK study arm. Follow-up examinations were set at day 1, day 7, day 30, and at the third and sixth month after the surgery. The primary outcome measure was best-corrected visual acuity (BCVA), whereas secondary outcome measures were contrast sensitivity, corneal aberrations, K-readings, corneal thickness, and complications after the surgery. Results: Seventy-two eyes completed the six-month follow-up interval. An insignificant difference in BCVA was observed at day 30 [control arm (n = 36); 0.80 ± 0.27 logarithm of the minimum angle of resolution (log MAR), study arm (n = 36); 0.78 ± 0.12 log MAR, P = 0.63], at third month [control arm; 0.65 ± 0.28 log MAR, study arm; 0.66 ± 0.10 log MAR, P = 0.93], and sixth month [control arm; 0.61 ± 0.28 log MAR, study arm; 0.62 ± 0.10 log MAR, P = 0.84] following surgery. In addition, an insignificant difference was observed between the two groups in terms of contrast sensitivity, corneal aberration, mean keratometric value, mean central corneal thickness, and complications following surgery. Conclusions: MK-SALK is non-inferior to FL-SALK for the treatment of superficial corneal opacities. By demonstrating comparable outcomes, our study alleviates apprehension and doubts about choosing between the techniques and allows the surgeon to make a choice based on his expertise and resources.

Keywords

• corneal opacity
• femtosecond laser-assisted salk
• microkeratome-assisted salk