TITLE:
Femtosecond Laser-Assisted Refractive Autokeratoplasty: A Pilot Study
AUTHORS:
Halina Viktorovna Sitnik, Aleksey Yurevich Slonimsky, Yuriy Borisovich Slonimsky, Tatsiana Aleksandrovna Imshenetskaya
KEYWORDS:
Keratoconus, Keratoplasty, Autokeratoplasty, Femtosecond Laser
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.6 No.2,
May
12,
2016
ABSTRACT: Purpose: To develop a new method of femtosecond laser-assisted refractive
autokeratoplasty (FRAK) in advanced keratoconus and to evaluate preliminarily
early clinical results. Methods: A total of 17 patients with stable advanced
keratoconus and a mean age of 33 ± 8.4 years were included in the study. FRAK
was performed in all cases with the IntraLase 60 kHz (Abbott Medical Optics
Inc.). A 2-step resection of corneal stroma was performed using the femtosecond
laser, with the generation of a circular corneal flap with wedge-shaped
profile. After flap removal, the corneal wound was sutured. Results: The
surgical procedure and early postoperative period were uneventful in all cases.
Mean uncorrected distance visual acuity (UDVA) improved significantly from 0.07
± 0.03 preoperatively to 0.26 ± 0.13 at 3 months after surgery. Improvement in
corrected distance visual acuity (CDVA) was observed in 94.1% of cases, with
76.5% of eyes showing an improvement of more than 3 lines. Between 3 and 6
months after surgery, an additional improvement was observed in UDVA and CDVA.
Corneal cylinder decreased significantly from 9.1 ± 3.8 D preoperatively to 4.4
± 2.75 D at 6 months postoperatively. Conclusions: FRAK may be an alternative
treatment in stable advanced keratoconus, allowing a significant visual
improvement and corneal regularization while saving the patient's own corneal
tissue. The non-penetrating nature of the surgical technique helps to minimize
the risks associated to this type of surgery. Further research is needed to
determine the functional long-term outcomes.