Comparing the efficacy and safety of femtosecond laser-assisted vs conventional penetrating keratoplasty: a meta-analysis of comparative studies

Update on Femtosecond Laser–Enabled Keratoplasty

“…Our updated analysis of BCVA and astigmatism are consistent with 2 of the only available meta-analyses on FLEK versus conventional PKP. 18,19 In the regression model, endothelial cell density was higher among FLEK versus conventional PKP using the 3 studies 5,15,16 that reported these data: +315.1 cells/mm 3 (95% CI, 272.4 to 357.7, P , 0.001). In the random-effects metaanalysis model, the risk difference in graft rejection rate was lower in FLEK with a mean risk difference of 25.29% (95% CI, 25.92% to 24.65%, P , 0.001).…”

“…Our updated analysis of BCVA and astigmatism are consistent with 2 of the only available meta-analyses on FLEK versus conventional PKP. 18,19…”

Advantages of femtosecond laser in various corneal transplantation procedures: A narrative literature review

“…In 2021, a meta-analysis study including 1991 eyes from 9 studies demonstrated that FSL-assisted PK was significantly superior to manual KP for BCVA and corneal astigmatism at 6 months postoperatively, although the differences were not statistically significant at 12 months postoperatively. [ 28 ] Another systemic review and meta-analysis that included 7 studies concluded that FSL-assisted PK was superior to manual PK in terms of visual outcome and endothelial cell preservation, although no superiority was found with regard to astigmatism. [ 29 ]…”

Femtosecond laser-assisted corneal transplantation

“…[ 9 ] However, no significant difference was observed in the visual outcomes between FSL-assisted and conventional PK after the 6-month postoperative follow-up period. [ 2 , 13 ] The induction of less astigmatism may be due to the geometry of the donor–recipient matching being more physiological and requiring less tight sutures. [ 12 ] Compared to manual suction trephine, it has been shown that there is less intraocular pressure (IOP) variation and less damage to endothelial cells during FSL trephination.…”

“…Corneal transplantation is one of the most effective procedures to improve poor vision due to corneal opacification, resulting from corneal pathologies such as infections, trauma, or degenerative diseases,[ 1 ] with an estimated 185,000 procedures performed globally each year. [ 2 ] Corneal transplantation includes penetrating keratoplasty (PK), anterior lamellar keratoplasty (ALK), deep ALK (DALK), Descemet stripping automated endothelial keratoplasty (DSAEK), and Descemet membrane endothelial keratoplasty (DMEK). In PK, the full-thickness cornea is removed and replaced with a healthy donor, while in ALK, DALK, DSAEK, and DMEK, the diseased corneal layers are replaced by the graft and the healthy corneal tissue is preserved.…”