One-year follow-up of femtosecond laser-assisted penetrating keratoplasty

Figures & data

Figure 1 Side profile of zig-square wound created by the femtosecond laser.

Table 1 Subject demographics, incisions dimensions and suturing technique

Patient number	Age (years)	Gender	Diagnosis	Combined procedure	Eye treated	Donor posterior diameter (mm)	Recipient posterior diameter (mm)	Suturing technique
1	56	Female	Lattice dystrophy	Nil	Left	7.8	7.8	16 interrupted
2	76	Female	Pseudophakic bullous keratopathy	Nil	Left	7.7	7.7	Continuous
3	76	Male	Pseudophakic bullous keratopathy	Nil	Left	7.7	7.7	Continuous
4	75	Female	Pseudophakic bullous keratopathy	Nil	Left	7.7	7.7	Continuous
5	63	Male	Chemical injury	CE-IOL	Left	7.7	7.7	16 interrupted
6	67	Male	Pseudophakic bullous keratopathy	Nil	Left	7.9	7.9	16 interrupted
7	55	Male	Pseudophakic bullous keratopathy	Nil	Right	7.7	7.7	16 interrupted
8	72	Female	Fuch’s endothelial dystrophy	CE-IOL	Left	7.9	7.9	Continuous
9	69	Female	LPI-induced bullous keratopathy	CE-IOL	Right	7.7	7.7	Continuous
10	72	Female	Fuch’s endothelial dystrophy	CE-IOL	Left	7.6	7.6	Continuous

Abbreviations: CE-IOL, cataract extraction with implantation of the intraocular lens; LPI, laser peripheral iridotomy.

Table 2 Visual acuity preoperatively and at postoperative month 12

Patient number	Preoperative		1 month		3 months		6 months		12 months
	UAVA	BSCVA	UAVA	BSCVA	UAVA	BSCVA	UAVA	BSCVA	UAVA	BSCVA
1	1	1	0.7	0.6	0.4	0.2	0.5	0.3	0.3	0.2
2	1.3	0.7	0.6	0.4	0.7	0.3	0.1	0	0.1	0
3	2	1.3	0.5	0.4	0.6	0.3	0.9	0.4	0.7	0.3
4	2	2	2	1.3	2	0.9	2	2	2	2
5	2	2	0.7	0.5	0.5	0.3	0.5	0.2	0.5	0
6	2	2	0.7	0.4	0.6	0.2	0.8	0.1	0.5	0.1
7	2	2	0.4	0.3	0.4	0.2	0.4	0	0.5	0.2
8	0.7	0.4	0.5	0.4	0.7	0.3	0.7	0.3	0.3	0.1
9	2	2	0.6	0.3	0.7	0.1	0.8	0	0.8	0.1
10	2	0.6	0.7	0.3	0.4	0.2	0.5	0.2	0.3	0.2

Abbreviations: BSCVA, best spectacle-corrected visual acuity; UAVA, unaided visual acuity.

Table 3 Manifest and Sim K astigmatism preoperatively and at postoperative month 12

Patient number	3 months		6 months		12 months
	MC (D)	Sim K* (D)	MC (D)	Sim K (D)	MC (D)	Sim K (D)
1	12	12.1	6	4.1	3	4.7
2	3	2.7	2.5	3.4	2.5	4.7
3	3.5	3.6	2.5	2.4	2.5	2.8
4	4	5	4	4.1	5	3.8
5	0.5	2.5	0.5	1.1	1.75	2.6
6	2	2.4	2.5	1.8	2.75	3.6
7	4	4.2	4	3.2	4.25	3.2
8	2.3	2.2	3.3	7.1	1	5
9	0.5	0.4	0.8	1.2	2	2.6
10	1	0.3	0	0.6	0.75	2.2

Note:

* Sim K astigmatism.

Abbreviations: MC, manifest cylinder; D, diopters.

Table 4 Endothelial cell density preoperatively and at postoperative month 12

Patient number	Preop ECD (cells/mm^2)	12 months ECD (cells/mm^2)	ECD loss (%)
1	2906	2036	30
2	3412	2564	25
3	2518	2108	16
4	3300	2857	13
5	2800	2224	21
6	2747	2217	19
7	2701	2208	18
8	3401	2567	25
9	2597	2083	20
10	3067	2475	19
		Mean	20.7

Abbreviation: Preop ECD, preoperative endothelial cell density.

Figure 2 Photographs and Optovue^® anterior segment optical coherence tomographic image from patient 5. (A) Preoperative photograph. (B) Postoperative photograph at week 8. (C) One year after femtosecond laser-assisted penetrating keratoplasty, there was a smooth anterior surface and good wound healing and apposition of the interlocking zig-square configuration.

Figure 3 Optovue^® anterior segment optical coherence tomographic image of patient 9 at 6 months after femtosecond laser-assisted penetrating keratoplasty, showing a well apposed donor-recipient junction with the zig-square incision.

Figure 4 Light microscopy of the donor corneal rim (hematoxylin and eosin, 40×), demonstrating precise incision by the femtosecond laser, with minimal disruption to the surrounding architecture.