Comparison between femtosecond laser mushroom configuration and manual trephine straight-edge configuration deep anterior lamellar keratoplasty

Shehadeh-Mashor, Raneen; Chan, Clara C.; Bahar, Irit; Lichtinger, Alex; Yeung, Sonia N.; Rootman, David S.

doi:10.1136/bjophthalmol-2013-303737

Cited by 58 publications

(28 citation statements)

References 23 publications

(26 reference statements)

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“…A case series study demonstrated that FSL-assisted DALK was an efficient and safe procedure for visual recovery in patients with anterior corneal diseases [20]. FSL-assisted DALK with mushroom configuration enabled faster visual recovery than manual DALK [21,22], although the final BCVA was comparable [21]. Salouti et al [23] recently reported that FSLassisted DALK was advantageous for reducing residual myopia and restoring corneal anatomy compared with manual DALK in patients with keratoconus, although postoperative BCVA and astigmatism were comparable.…”

Section: Femtosecond Laser-assisted Dalkmentioning

confidence: 99%

Application of Femtosecond Laser in Anterior Segment Surgery

Han

Liu

Mohamed-Noriega

2020

Journal of Ophthalmology

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Femtosecond laser (FSL) is a near-infrared laser that can create reliable and reproducible tissue cutting with minimal damage to adjacent tissue. As the laser can also create incisions with various orientations, depths, and shapes, it is expected to be a useful tool for anterior segment surgery, such as cornea, refractive, and cataract surgery. In this review, the authors will introduce the application of FSL in various anterior segment surgeries and discuss the results of studies regarding the efficacy and safety of FSL in cornea, refractive, and cataract surgery. Experimental studies regarding the potential use of FSL will also be introduced. The studies discussed in this review suggest that FSL may be a useful tool for improving the prognosis and safety of surgeries of the anterior segment.

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Section: Femtosecond Laser-assisted Dalkmentioning

confidence: 99%

Application of Femtosecond Laser in Anterior Segment Surgery

Han

Liu

Mohamed-Noriega

2020

Journal of Ophthalmology

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“…This device helps in the construction of 'zig-zag' and 'mushroom' wounds in both the recipient and donor [25][26][27][28][29][30] . Nonetheless femtosecond lasers do not seem to be able to create very deep lamellar stromal cuts or to leave a uniform thickness of the recipient bed: two very important conditions for good visual recovery.…”

Section: New Devicesmentioning

confidence: 99%

Deep Anterior Lamellar Keratoplasty: Surgical Technique, Indications, Clinical Results and Complications

Sarnicola¹,

Sarnicola²,

Sarnicola³

2015

Cornea

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Deep anterior lamellar keratoplasty (DALK) is currently the procedure of choice to restore transparency and curvature in corneal stromal diseases with a healthy endothelium. Preserving the endothelium avoids endothelial rejection and provides a good and stable endothelial cell count, allowing good long-term graft survival. Several surgical techniques have been proposed over the last years, the most common of which include layer-by-layer manual dissection, hydrodissection, viscodissection, big bubble (needle or cannula) and air-viscobubble. Descemet's membrane rupture represents the most common complication, even in expert hands. The penetrating keratoplasty conversion rate gradually decreases as surgeons become more experienced and learn to manage Descemet's membrane ruptures. Being able to repair the ruptures would increase the success of DALK and allow patients to benefit from all of its advantages. a b cGüell JL (ed): Cornea.

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“…Recently, shaped trephination profiles have also been used to create a better match between the donor button and the recipient stromal bed in FSL-ALK and deep ALK, with the advantages of better mechanical stability and improved healing of stepped corneal wounds [26][27][28][29] .…”

Section: Femtosecond Laser-assisted Lamellar Keratoplastymentioning

confidence: 99%

Femtosecond Laser-Assisted Penetrating and Lamellar Keratoplasty

Mastropasqua¹,

Nubile²

2015

Cornea

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The continuous evolution of corneal transplantation has recently demonstrated that the surgical approach based on selective lamellar keratoplasty represents the gold standard for the treatment of corneal disease. The replacement of the diseased corneal layers via anterior lamellar or endothelial keratoplasty clearly gives advantages to patients in terms of safety and outcomes. However, the classical method of penetrating keratoplasty has also recently undergone evolution and refinements. The introduction of femtosecond laser technology to clinical practice, after its wide use for refractive surgical corneal procedures, allowed for a significant refinement in terms of precision and customization of both penetrating and lamellar keratoplasty. The main advantages of using femtosecond lasers are represented by the possibility of performing complex-shaped trephination in both the donor and recipient tissues (for example, top-hat or zig-zag cut profiles) and the great precision of lamellar dissection. However, cut quality and interface smoothness still represent critical points to be improved.

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Comparison between femtosecond laser mushroom configuration and manual trephine straight-edge configuration deep anterior lamellar keratoplasty

Abstract: FSL or trephine DALK are viable options for keratoconus, ectasia and corneal scars. Earlier visual recovery occurs with FSL mushroom configuration compared with MT straight-edge DALK.

Cited by 58 publications

References 23 publications

Application of Femtosecond Laser in Anterior Segment Surgery

Application of Femtosecond Laser in Anterior Segment Surgery

Deep Anterior Lamellar Keratoplasty: Surgical Technique, Indications, Clinical Results and Complications

Femtosecond Laser-Assisted Penetrating and Lamellar Keratoplasty

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