Guoji Yanke Zazhi (Dec 2014)
Early clinical research on the femtosecond laser assisted penetrating keratoplasty
Abstract
AIM: To evaluate the therapeutic effects and safety of femtosecond laser assisted penetrating keratoplasty(FS-PKP).METHODS: In the retrospective case series study, 46 cases(48 eyes)with FS- PKP holds were analyzed. Preoperative best corrected visual acuity(BCVA)was 2.35±1.01(with a standard logarithmic eye chart). Opacities were all from epithelium to endothelium, including keratoconus, keratolukoma and corneal scarring etc. The full-thickness corneal donor-recipient grafts in different diameter and incision kerfangle were made by femtosecond laser in keratoplasty. The patients were treated according to the conventional penetrating keratoplasty after surgery. Evaluation indexes included preoperative and postoperative 1,6,10mo uncorrected visual acuity(UCVA), BCVA, corneal astigmatism(CA)and surgical complications. Forty-three cases(44 eyes)with traditional PKP were as control group. The data of two groups were analyzed by mean comparison of two groups and Chi-square test in SPSS 18.0. RESULTS: All the operations were completed successfully, postoperative visual acuity of all patients had different degrees of increase. Comparison with the postoperative UCVA of traditional PKP surgery, UCVA was 3.48±0.43 and 2.97±1.14 at 1mo after operation, respectively, with statistically significant difference(P=0.009). The UCVA was 3.86±0.25 and 3.74±0.73 at 3mo after operation, respectively; the UCVA was 4.04±0.23 and 3.98±0.29 at 6mo after operation, respectively, with no statistically significant difference(P=0.146, P=0.56). In FS-PKP group, BCVA was better than traditional PKP surgery group, with statistically significant difference(P=0.002). While there had no statistically significant difference between two groups of BCVA at 6, 10mo after operation(P6mo=0.132, P10mo=0.47). The incidence of complication of FS-PKP surgery, such as postoperative astigmatism, postoperative intraocular pressure and postoperative incision dehiscence were significantly lower than the one of traditional PKP surgery(PCONCLUSION:Compared with traditional penetrating keratoplasty, FS-PKP provides significantly faster visual recovery in the early postoperative period, and induces significantly less corneal astigmatism and lower incidence of complication. It reflected the clinical superiority of this new technology.
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