THE PRIMARY EXPERIENCE AND SHORT-TERM RESULTS OF FEMTOLASER POSTERIOR KERATOPLASTY (DSEK) WITH FORMATION OF TRANSPLANT FROM ENDOTHELIUM SIDE

Abstract

The most often applied operation in case of pathology of endothelium of cornea is the automated keratoma endothelial transplantation with descemetorexis. At the same time, surplus amount of stroma and uneven thickness of transplant limit the achievement of potential visual acuity. The development of laser femtosecond technologies made it possible to form transplants of symmetric profiles and desired thickness. Besides, the proofs exit concerning damage of epithelium under effect of femtolaser near the object. The article presents the primary experience and short-term results of endothelial keratoplasty using transplant formed with femtosecond laser LDV Z6 (Ziemer, Switzerland) from endothelium side. The surgery was applied to 6 patients including cases of end-to-end keratoplasty, with primary and secondary dystrophy, artiiridofaction, avitria and other concomitant pathology. The period of monitoring consisted 6 months. The effectiveness evaluated according presence of intra- and post-surgery complications, recovery of transparence of cornea, evenness and thickness of transplant and density of endothelium cells. The recovery of transparency of cornea was achieved in all patients. During post-surgery period both full and partial separation of transplant occurred. The mean minimal thickness of transplants made up 76.6 mkm and mean maximal thickness — 93.3 mkm. The difference in thickness within the limits of single transplant among all grafts consisted 1720±162 kl/mm 2. It was first demonstration of clinical possibility and effectiveness of implementation of laser femtosecond endothelium kerartoplasty with formation of graft from endothelium side.

Keywords

endothelial keratoplasty with descemetorexis / femtosecond laser

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