 |
|
Preliminary Results of Femtosecond Laser–Assisted Descemet Stripping Endothelial Keratoplasty
Yanny Y. Y. Cheng, MD;
Fred Hendrikse, MD, PhD;
Elisabeth Pels, PhD;
Robert-Jan Wijdh, MD;
Hugo van Cleynenbreugel, MD;
Cathariena A. Eggink, MD, PhD;
Gabriel van Rij, MD, PhD;
Wilhelmina J. Rijneveld, MD;
Rudy M. M. A. Nuijts, MD, PhD
Arch Ophthalmol. 2008;126(10):1351-1356.
Objective To evaluate the preliminary visual results of femtosecond laser–assisted Descemet stripping endothelial keratoplasty (FS-DSEK).
Methods We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent FS-DSEK. Best spectacle-corrected visual acuity (BSCVA), refraction, corneal topography, and endothelial cell density were measured preoperatively and 3 and 6 months after FS-DSEK. Corneal thickness was measured using an optical coherence tomography technique.
Results The average BSCVA of 11 eyes with normal visual potential significantly improved from 20/110 ± 4 lines to 20/57 ± 1 line at 6 months (P < .007). At 6 months, the mean (SD) hyperopic shift was 2.24 (2.3) diopters (D). Preoperative and 6 months postoperative refractive astigmatism were –0.75 (0.9) D and –1.58 (1.1) D (P = .01), but the topographic astigmatism did not change postoperatively (P = .95). Mean (SD) endothelial cell density at 6 months was 1368 (425) cells/mm2. There was a persistent deswelling of the graft up to 3 months postoperatively. Complications included graft dislocations requiring repositioning (20%), pupillary block glaucoma (5%), epithelial ingrowth (5%), and primary graft failure (5%).
Conclusions Femtosecond laser–assisted Descemet stripping endothelial keratoplasty was effective in treating endothelial failure with minimal induced refractive astigmatism, limited improvement of BSCVA, and induction of a hyperopic shift. Endothelial cell count and dislocation rate were significant, which may be related to the surgical technique.
Author Affiliations: Department of Ophthalmology, University Hospital Maastricht, Maastricht (Drs Cheng, Hendrikse, and Nuijts), Cornea Bank Amsterdam, Netherlands Institute for Neuroscience, Amsterdam (Dr Pels), Department of Ophthalmology, University Medical Center Groningen, Groningen (Dr Wijdh), The Rotterdam Eye Hospital (Dr van Cleynenbreugel) and Department of Ophthalmology, Erasmus Medical Center (Dr van Rij), Rotterdam, Department of Ophthalmology, Radboud University Nijmegen Medical Center, Nijmegen (Dr Eggink), and Department of Ophthalmology, Westfries Gasthuis, Hoorn (Dr Rijneveld), the Netherlands.
|
