Visual quality after femtosecond laser-assisted deep anterior lamellar keratoplasty with big-bubble method for the treatment of keratoconus / 眼科新进展

ABSTRACT

Objective To observe the visual outcomes of big-bubble deep anterior lamellar keratoplasty (DALK) for the treatment of keratoconus using a femtosecond laser.Methods A total of 30 patients (50 affected eyes) with keratoconus were enrolled in the study by the self control observation method.All the patients were treated with femtosecond laser assisted DALK by large bubble method,and the curative effect was observed.Results All the 30 patients underwent the surgery successfully.In the early time after the surgery,the corneal grafts were transparent,the corneal physiological thickness was restored,and the grafts fitted the implant bed elastic layer well.The uncorrected visual acuity and the best corrected visual acuity on day 7,1 month,6 months and 1 year after surgery were higher than those before surgery (all P ＜ 0.05),but there was no significant difference between above time points (all P ＞ 0.05).The corneal curvature and corneal astigmatism were significantly decreased after surgery,the thickness of the thinnest cornea was significantly increased after surgery (all P ＜0.05),but there was no significant difference between the different time points after surgery (all P ＞ 0.05).The endothelial cell density before surgery and 1 year after surgery was (2989.34 ±294.52) · mm-2 and (2821.19 ±325.51) · mm-2,while loss rate of endothelial cell was (5.62 ± 0.56)％,but there was no significant difference between different time points after surgery (all P ＞ 0.05).There were no complications during the surgery,but wound dehiscence occurred in 1 eye,loose suture in 1 eye,and stromal rejection in 1 eye,and there was no other complication after surgery.Conclusion It is safe and effective of femtosecond-laser assisted DALK by a big-bubble method to treat keratoconus,and it is a good choice for patients with advanced keratoconus.