Gadhvi, KA;
Romano, V;
Fernández-Vega Cueto, L;
Aiello, F;
Day, AC;
Gore, DM;
Allan, BD;
(2020)
Femtosecond Laser–Assisted Deep Anterior Lamellar Keratoplasty for Keratoconus: Multi-surgeon Results.
American Journal of Ophthalmology
, 220
pp. 191-202.
10.1016/j.ajo.2020.07.023.
Preview |
Text
Allan_Femtosecond Laser–Assisted Deep Anterior Lamellar Keratoplasty for Keratoconus_AAM.pdf Download (493kB) | Preview |
Abstract
PURPOSE: To compare the clinical outcomes in femtosecond laser–assisted deep anterior lamellar keratoplasty (F-DALK) to manual non-laser deep anterior lamellar keratoplasty (M-DALK) for keratoconus in a multi-surgeon public healthcare setting. DESIGN: Single-center, comparative, retrospective interventional case series. METHODS: Population: Consecutive cases of keratoconus treated with big-bubble F-DALK from August 1, 2015, to September 1, 2018 and big-bubble M-DALK from September 1, 2012, to September 30, 2016. Setting: Moorfields Eye Hospital, London. Observations: Data on preoperative status, operative details, intraoperative and postoperative complications, secondary interventions, and visual outcomes were archived on a customized spreadsheet for analysis. Main Outcome Measures: Rate of intraoperative perforation and conversion to penetrating keratoplasty (PK) and the percentage of patients, post removal of sutures (ROS), with corrected distance visual acuity (CDVA) ≥20/40. RESULTS: We analyzed 58 eyes of 55 patients who underwent F-DALK and 326 eyes of 309 patients who underwent M-DALK. Intraoperative perforation of Descemet membrane occurred in 15 of 58 (25.9%) F-DALK cases compared to 148 of 326 (45.4%) M-DALK cases (P = .006). Intraoperative conversion to PK was carried out in 2 of 58 (3.4%) F-DALK cases compared to 80 of 326 (24.5%) M-DALK cases (P = .001). Post ROS, 86.5% of F-DALK eyes had a CDVA of ≥20/40 (15 ± 7.3 months after surgery) compared to 83.7% of M-DALK eyes (24.9 ± 10.6 months) (P = .825). CONCLUSION: Laser automation of some steps in DALK for keratoconus may reduce the rate of intraoperative Descemet perforation and the conversion to PK in a multi-surgeon setting.
| Type: | Article |
|---|---|
| Title: | Femtosecond Laser–Assisted Deep Anterior Lamellar Keratoplasty for Keratoconus: Multi-surgeon Results |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajo.2020.07.023 |
| Publisher version: | https://doi.org/10.1016/j.ajo.2020.07.023 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10157050 |
Archive Staff Only
 |
View Item |
