Femtosecond Laser Penetrating Keratoplasty with Conical Incisions and Positional Pikes
Jonas J. B.
Dept. of Ophthalmology, Mannheim University
Purpose: To describe the possibility to create congruent conical incisions with positional edges and corresponding notches for the donor button and the recipient bed in penetrating keratoplasty using the new femtosecond laser technology.
Method: The study included 10 freshly enucleated porcine eyes. Using a femtosecond laser (20/10 Perfect Vision, Am Taubenfeld 21/1, D-69123 Heidelberg, Germany), various corneal buttons were prepared with an outer (epithelial) diameter ranging between 5.0 mm and 7.5 mm, an inner (endothelial) diameter ranging between 6.0 mm and 9.0 mm, and a conical angle between the direction of the incision and the sagittal axis varying between 0° and 60°. Additionally, 4 positional pikes were carved into the donor button, and 4 corresponding notches were created into the recipient bed.
Results: For all eyes included in the study, the corneal buttons could be prepared without major difficulties. The corneal buttons could easily be repositioned into their original beds as well as into the recipient beds of other eyes in which the recipient beds were created with the same diameter and the same conical angle as for the donor button. The time taken for the preparation of the corneal buttons including positioning of the corneal contact lens, the laser application itself, and the removal of the corneal button was less than 5 minutes in all cases.
Conclusions: In corneal surgery, femtosecond laser te
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