Improving Boston type 1 keratoprosthesis procedure: one-touch femtosecond-assisted preparation and centration of donor carrier tissue.

PURPOSE: We describe a technique to avoid decentration of the visual axis of the Boston type 1 keratoprosthesis (Kpro), performing 2 concentric trephinations with femtosecond laser. METHODS: Two concentric side cuts were performed in a donor cornea using the 150-kHz Intralase FS laser. Within the same applanation procedure, an 8.5-mm-diameter anterior side cut was performed, followed by a concentric 3-mm-diameter anterior side cut. RESULTS: The technique was successfully replicated in 7 cases. CONCLUSIONS: Femtosecond laser-assisted double trephination results in a correctly prepared donor cornea, and in an inner side precisely matched with the prosthesis. At the end of the surgery, the Kpro was correctly centered.