Femtosecond laser shaped penetrating keratoplasty: one-year results utilizing a top-hat configuration.

PURPOSE

To evaluate use of a femtosecond laser to create shaped corneal grafts in penetrating keratoplasty (PK) in treatment of corneal disease.

DESIGN

Prospective, nonrandomized clinical study.

METHODS

Six eyes of six patients were treated in this initial series. Two had herpetic scarring, two had pseudophakic bullous keratopathy, one had Fuchs endothelial dystrophy and one had endothelial dystrophy with a corneal scar. Preoperative best spectacle-corrected visual acuity (BSCVA) ranged from count fingers to 20/50. Donor and recipient corneas were cut in a "top-hat" shaped configuration utilizing a 15-kHz femtosecond laser.

RESULTS

All eyes were successfully treated without intraoperative complications. Mean time to complete suture removal was 7.0 +/- 1.9 months (range, 4.1 to 9.7 months). At the one-year postoperative exam, mean endothelial cell density was 2030 +/- 600 cells/mm(2) (range, 1007 to 2497 cells/mm(2)), which was comparable with cell density measured in a prior series of traditional PKs (P = .21). BSCVA ranged from 20/400 to 20/25. In two eyes, preexisting retinal conditions limited visual improvement following transplantation.

CONCLUSIONS

Use of the femtosecond laser allowed precise dissection of donor and recipient corneas even when significant opacities were present. The use of a top-hat configuration allowed for an increased area of wound healing in these eyes.