Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Korea.
Cornea. 2010 Aug;29(8):924-9. doi: 10.1097/ICO.0b013e3181a38ff1.
To evaluate the feasibility of a femtosecond (FS) laser-assisted keratolimbal allograft (KLAL) technique.
Interventional case series.
This study included 3 patients with extensive limbal stem cell deficiency. The donor cornea was dissected with an FS laser (IntraLase FS laser, 60 kHz) using a ring procedure, without outer side cutting for the limbal graft, after a penetrated dissection of the donor cornea prior to penetrating keratoplasty (PKP). The depth and width of the ring procedure were adjusted for each individual patient. Further extension to the periphery of the sclerocorneal tissue of the donor graft was performed with a diamond knife. In a case of KLAL alone, the unhealthy limbal tissue of the recipient was removed with the FS laser by the same method employed in donor preparation. One patient underwent KLAL alone, and 2 patients underwent KLAL combined with PKP. The patients were followed up for a maximum of 10 months.
Limbal grafts were even and thin, as expected. The case with KLAL alone showed the fastest epithelization of the recipient cornea. The 2 cases of combined KLAL and PKP showed excellent approximation between recipient and donor tissue. The ocular surfaces have been stable for 8 months in case 1 and 10 months in cases 2 and 3.
FS laser-assisted KLAL has potential advantages in terms of simplicity and speed as compared with conventional techniques.
评估飞秒（FS）激光辅助角膜缘同种异体皮片移植术（KLAL）的可行性。
干预性病例系列研究。
本研究纳入了 3 例广泛角膜缘干细胞缺乏症患者。使用 FS 激光（IntraLase FS 激光，60 kHz），采用环式程序进行供体角膜分离，无需进行外侧边缘切割供体角膜缘皮片，然后再进行穿透性角膜移植术（PKP）。环式程序的深度和宽度根据每位患者的情况进行调整。用钻石刀进一步向供体巩膜组织的周边延伸。在 KLAL 单独应用的情况下，用与供体准备相同的方法，用 FS 激光切除受体不健康的角膜缘组织。1 例患者单独接受 KLAL，2 例患者接受 KLAL 联合 PKP。患者随访时间最长为 10 个月。
角膜缘移植物均匀且薄，如预期的那样。单独接受 KLAL 的病例显示出受体角膜最快的上皮化。2 例 KLAL 联合 PKP 的病例显示出受体和供体组织之间极好的吻合。1 例患者的眼表面稳定了 8 个月，2 例患者稳定了 10 个月。
与传统技术相比，FS 激光辅助 KLAL 在简单性和速度方面具有潜在优势。
