Long Term Results of Femtosecond Laser-Assisted Sutureless Anterior Lamellar Keratoplasty “FALK” Mohamed Abou Shousha, MD, Sonia H. Yoo, MD, William Feuer, MS, Carol L. Karp, MD, Terrence P. O'Brien, MD, William W. Culbertson, MD, Eduardo Alfonso, MD Financial Disclosure Sonia H. Yoo with Abbott (L) and Carl Zeiss Meditec (L) and William W. Culbertson with Abbott (L). Other authors have no financial interest in the subject matter of this poster.
Long Term Results of Femtosecond Laser-Assisted Sutureless Anterior Lamellar Keratoplasty “FALK” Mohamed Abou Shousha, MD, Sonia H. Yoo, MD, William Feuer,
Jan 19, 2018
Methods Retrospective, non-comparative, interventional case series 13 eyes of 13 consecutive patients who underwent FALK for anterior corneal pathologies. Main Outcome Measures: Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA) Manifest refraction Postoperative complications Need for adjunctive surgery. Methods
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Long Term Results of Femtosecond Laser-Assisted Sutureless Anterior Lamellar Keratoplasty
“FALK”
Mohamed Abou Shousha, MD, Sonia H. Yoo, MD, William Feuer, MS, Carol L. Karp, MD, Terrence P. O'Brien, MD, William W. Culbertson, MD, Eduardo Alfonso, MD
Financial DisclosureSonia H. Yoo with Abbott (L) and Carl Zeiss Meditec (L) and William W. Culbertson with Abbott (L). Other authors have no financial interest in the subject matter of this poster.
Purpose
To evaluate the long term results of Femtosecond Laser-Assisted Sutureless
Anterior Lamellar Keratoplasty (FALK) for anterior corneal pathologies.
Methods
Retrospective, non-comparative, interventional case series
13 eyes of 13 consecutive patients who underwent FALK for anterior corneal pathologies.
Main Outcome Measures:
Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA) Manifest refraction Postoperative complications Need for adjunctive surgery.
Methods
Methods
Follow-up ranged from 12 to 60 months (mean= 29 months). BSCVA was significantly improved over preoperative values at the 12, 18, 24 and 36 month visits.
Results: BSCVA
Methods
% of patients achieved BSCVA > 20/30 :
54% at the 12 month visit.50% at the 18 month visit.33% at the 24 month visit.
The BSCVA of the eye that completed the 60 month visit was 20/50. BSCVA > 20/50 was recorded for all patients at all examination times, except for one eye owing to a preexisting cataract.
Results: BSCVA
Methods
Patients achieved a mean gain of 5 lines of BSCVA at the 6, 12, 18 and 24 months visit, 4 lines at the 36 month visit and 6 lines at the 60 month visit. At a mean of 5 weeks postoperatively, 83.3% of patients achieved BSCVA within 2 lines of that recorded at the 24 month visit.
Results: BSCVA
Methods
At the 12 month visit, mean spherical equivalent and refractive astigmatism were -0.4 diopters (D) and 2.2 D, respectively, with no significant shift from preoperative values or values recorded along different follow-up visits.
Results: Manifest Refraction
Preoperative Postoperative 6m 12 m 18 m 24m 36m 60m
Number of Eyes 13 13 13 12 12 5 1
Mean spherical equivalent (diopters)
-1.4 ±2.3 D -1.2 ±3.2 D -0.4 ±3.4 D -0. 1 ±3 D 0.17 ±2.8 D 0.2 ±2.8 D -3.8
Mean Cylinder(diopters)
1.8 ±2.2 2.6 ±2.2 2.2 ±2.3 1.7 ±1.4 1.8 ±1.6 1.4 ±1.2 2
Data presented as mean ±SD [range]m: months
Methods
1. Phototherapeutic keratectomy : 2 eyes at the 4th and 10th postoperative month
2. Photorefractive Keratectomy: 2 eyes at the 4th and 16th postoperative month.
3. Cataract extraction: 1 eye at the 24th postoperative month
Results: Adjunctive Surgeries
Preoperative slit lamp image (a) shows a visually significant central corneal scar. The depth of the scar that was used to plan the femtosecond lamellar cut was determined from the optical coherence tomography (OCT) image (c). Postoperative slit lamp image (b) discloses the presence of a residual scar. Thickness of the residual scar was measured from OCT image (d). PTK to the stromal bed was done 4 months postoperatively and resulted in a gain of 2 BSCVA lines. Post- PTK OCT image (e) shows a significant reduction of the stromal scar tissue and a thin residual stromal bed of only 171 µm. The patient shows stability of BSCVA and manifest refraction up till the end of a follow up period of 35 months.
Methods Residual scar (6 eyes) Immediate postoperative stromal bed interface haze (3 eyes) Persistent dry eye (3 eyes) Anisometropia (2 eyes) High postoperative astigmatism (>5 D) (2 eyes) Surface Haze after adjunctive PRK (1 eye) Suspicious ectasia (1 eye) Immediate postoperative recurrence of pathology (1 eye) Epithelial ingrowth (1 eye)
Results: Complications
Epithelial ingrowth in the interface.
Residual Scars
• Slit lamp image (a) shows a preoperative visually significant central corneal scar. Five months postoperative FALK, the slit lamp image (b) discloses a residual stromal scar that was not considered significant enough to warrant an adjunctive surgery. Sixty months postoperatively slit lamp image (c) shows fading of the residual stromal scar.
Residual Corneal scar Despite the incomplete removal of scar tissue in 6 eyes, those cases gained an average of
6.5 lines of BSCVA (±10.5, -1 to 27) at the 6 month visit compared to preoperative BSCVA. With the exception of those two cases where PTK was performed, the residual scar was
not clinically significant enough to warrant an adjunctive surgery
Methods
FALK improves the BSCVA of patients with anterior corneal pathologies with rapid visual rehabilitation and less induced astigmatism. Favorable results of FALK remained stable throughout the follow-up period with no sight threatening complications.
Conclusions
Related Documents
