Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.
Curr Opin Ophthalmol. 2019 Jul;30(4):256-263. doi: 10.1097/ICU.0000000000000574.
A survey of the recent literature of deep anterior lamellar keratoplasty using femtosecond laser technology.
There are several recent reports in the literature assessing technique and outcomes of deep anterior lamellar keratoplasty done with a femtosecond laser trephination. Most of these reports are laboratory studies and small case series with short-term outcomes. The laser technology is expensive and may not produce better results than conventional manual techniques. However, there are several theoretical advantages to femtosecond laser incisions in deep anterior lamellar keratoplasty that should be explored, including possible increased success of Descemet's membrane separation from stroma during surgery as well as postsurgical astigmatism benefits, earlier suture removal, and increased wound strength and healing.
Femtosecond laser trephination in the setting of DALK may improve the technique by decreasing the number of descemet's membrane ruptures and improving short-term and long-term outcomes as compared with manual techniques. However, there is no consensus on a standardized approach for wound design or postoperative management. The literature would benefit from a prospective randomized controlled trial.
利用飞秒激光技术进行深层前板层角膜移植的文献调查。
目前有一些关于使用飞秒激光环钻进行深层前板层角膜移植的技术和结果的最新文献报道。这些报道大多是实验室研究和小病例系列，其随访时间较短。激光技术昂贵，其效果可能并不优于传统的手动技术。然而，飞秒激光切口在深层前板层角膜移植中有一些理论上的优势值得探索，包括在手术中可能增加将后弹力膜从基质上分离的成功率以及术后散光获益、更早去除缝线、增加伤口强度和愈合。
与手动技术相比，飞秒激光环钻在 DALK 中可能通过减少后弹力膜破裂的数量来改善手术技术，并改善短期和长期结果。然而，对于伤口设计或术后管理的标准化方法尚未达成共识。该文献需要进行前瞻性随机对照试验。
