scholarly journals Observation on ultrastructure and histopathology of cornea following femtosecond laser-assisted deep lamellar keratoplasty for acute corneal alkaline burns

Cornea ◽  
2016 ◽  
Vol 35 (10) ◽  
pp. 1289-1294 ◽  
Author(s):  
Suxia Li ◽  
Ting Wang ◽  
Jiang Bian ◽  
Fuhua Wang ◽  
Shasha Han ◽  
...  

Cornea ◽  
2006 ◽  
Vol 25 ◽  
pp. S41-S46 ◽  
Author(s):  
Yu-Feng Yao ◽  
Yu-Qi Jin ◽  
Bei Zhang ◽  
Ping Zhou ◽  
Yong-Ming Zhang ◽  
...  

Author(s):  
I.S. Tkachenko ◽  
◽  
B.E. Malyugin ◽  
S.A. Borzenok ◽  
D.S. Ostrovskiy ◽  
...  

Purpose. To rationale experimentally the use of a viscoprotection of the corneal endothelium on the graft formed with a femtosecond laser for the descemet stripping endothelial keratoplasty. Material and methods. In our study, we used 12 pig's corneoscleral discs. The preservation time before the experiment averaged 12±4 hours. The corneas were divided into 2 groups. In the operating room, the graft was formed using an LDV Z8 femtosecond laser (Ziemer, Switzerland) from the endothelial side. Before applanation of the donor cornea and femtolaser head, a 1% solution of hydroxypropyl methylcellulose (HPMC) was applied to the endothelium - experimental group. The control group was appraised according to the standard technique, with the application of a few drops of a solution for storing the corneas. Then the applanation was monitored and evaluated by laser optical coherence tomography. Then the graft was separated from the bed and transferred to a conservation medium. Under laboratory conditions, to determine the viability of endothelial cells, the graft was stained with a «vital» dye with the commercial name Life and Dead (Abcam, UK) and placed in a confocal laser scanning microscope. Endothelial cells were counted using the ImageJ software. Results. In the experimental and control groups, the number of living endothelial cells (EC) was 91.06±1.49% and 83.86±2.14%, respectively (p<0.001). The number of dead ECs in the control group was 7.2±0.65% more than in the experimental group and amounted to 16.14±2.14% and 8.94±1.49%, respectively (p<0.001). Conclusion. The study demonstrated that the use of viscoprotection of the corneal graft endothelium for posterior lamellar keratoplasty is quite effective, and significantly reduces the loss of EC at the stage of cutting out the graft with a femtosecond laser. Key words: descemet stripping endothelial keratoplasty, femtosecond laser, vital dyes.


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Radwan Almousa ◽  
Sheraz M Daya

Purpose: To compare the visual outcome of femtosecond laser-assisted anterior keratoplasty (FSALK) and microkeratome-assisted anterior lamellar keratoplasty (MALK) in anterior corneal dystrophy.  Methods: retrospective comparative chart review of 7 eyes that underwent FSALK and 7 eyes that underwent MALK. The primary outcome was the visual outcome of both procedures. The secondary outcome was the recurrence of the corneal dystrophies.Results: Mean follow-up time was 30±14(7-51) months for the FSALK group and 127±28(80-127) months for the MALK group. In the FSALK group the preoperative best spectacle-corrected visual acuity (BSCVA) improved from 20/63 to 20/25 at 36 months. In the MALK group there was 1 eye with documented BSCVA over 36 months follow-up; it improved from 20/160 preoperatively to 20/32 at 36 months. Uncorrected visual acuity (UCVA) at 36 months improved from 20/100 preoperatively to 20/63 in the FSALK group and from 20/200 preoperatively to 20/63 in the MALK group. Five eyes with Reis-Bucklers showed a clinical recurrence at a mean of 142±13(125-152) months. Two eyes with granular dystrophy showed a clinical recurrence at 23 and 80 months of follow-up. One eye in the MALK group had epithelial ingrowth. One eye in the FSALK group with compromised ocular surface due to 2 previous penetrating keratoplasty, suffered bacterial keratitis that ended up with corneal scarring. Conclusion: Both procedures improve visual outcome for anterior corneal dystrophy. FSALK has theoretical advantages over MALK; however, larger prospective studies are needed to prove this.


2021 ◽  
pp. 112067212110590
Author(s):  
Cristina Monterosso ◽  
Marco Antonini ◽  
Antonio Di Zazzo ◽  
Daniele Gaudenzi ◽  
Luigi Caretti ◽  
...  

Purpose To evaluate postoperative safety of femtosecond laser deep anterior lamellar keratoplasty performed with an innovative anvil profile in keratoconus patients. Methods This is a single-center, retrospective cohort study. We reviewed medical records of 89 keratoconus patients that underwent femtosecond laser deep anterior lamellar keratoplasty surgery (46 eyes) and manual deep anterior lamellar keratoplasty (47 eyes). Inclusion criteria required: age > 18 years old, best-corrected visual acuity < 0.3 LogMAR, continuous suture of the graft, postoperative immunomodulant regimen with dexamethasone 0.1% for 6 months and at least 12 months follow-up. Previous eye surgery, hydrops, and other ocular disease were excluded. The main outcome measures were postoperative events: rejections, persistent epithelial defects, and graft failures. Results During the follow-up (20 ± 6 months) graft rejection was diagnosed in 0 of femtosecond laser deep anterior lamellar keratoplasty versus 6 (17%) of manual deep anterior lamellar keratoplasty [ p 0.027], persistent epithelial defect in 0 of femtosecond laser deep anterior lamellar keratoplasty versus in 4 (11%) of manual deep anterior lamellar keratoplasty [ p 0.048] and graft failure occurred in 4 (11%) of manual deep anterior lamellar keratoplasty. The best-corrected visual acuity, after removal of sutures, was better in the femtosecond laser deep anterior lamellar keratoplasty group 0.09 ± 0.08 LogMAR versus 0.16 ± 0.13 LogMAR in manual deep anterior lamellar keratoplasty [ p 0.035] group although refractive spherical equivalent and cylinder, topographic average keratometry and cylinder were similar. Conclusions Anvil-shaped femtosecond laser deep anterior lamellar keratoplasty in keratoconus surgery increases safety and readiness of recovery, decreasing the incidence of corneal rejection, epithelial defects, graft failures, and producing better best-corrected visual acuity after removal of sutures.


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