Femtolaser refractive autokeratoplastic: first results and prospects
Purpose. Development of a new method of autokeratoplasty using of femtosecond laser in patients with advanced keratoconus and evaluation of early results of treatment.Patients and methods. 17 patients with advanced stable keratokonus were included in the study (15 men, 2 women) mean age 33±8.4 years...
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| Language: | Russian |
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Ophthalmology Publishing Group
2015-10-01
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| Series: | Oftalʹmologiâ |
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| Online Access: | https://www.ophthalmojournal.com/opht/article/view/255 |
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| author | H. V. Sitnik A. Yu. Slonimsky Yu. B. Slonimsky |
| author_facet | H. V. Sitnik A. Yu. Slonimsky Yu. B. Slonimsky |
| author_sort | H. V. Sitnik |
| collection | DOAJ |
| description | Purpose. Development of a new method of autokeratoplasty using of femtosecond laser in patients with advanced keratoconus and evaluation of early results of treatment.Patients and methods. 17 patients with advanced stable keratokonus were included in the study (15 men, 2 women) mean age 33±8.4 years old. Stage III of keratokonus was diagnosed in 3 eyes, stage IV was revealed in 14 eyes. Minimal corneal thickness was 381±33.82 μм, keratometric indices Ks 60.1±5.7 D, Kf 54.8±5.8 D, cylinder 9.1±3.8 D. Femtolaser-assisted refractive autokeratoplasty (FRAK) was performed with the use of «IntraLase 60 kHz». The idea of our method consists in performing of 2‑step resection of corneal stroma using femtosecond laser. Firstly, circular corneal cut should be made at an angle to the surface is fulfilled on distance 1.5‑2.0 mm from the limbus to a depth of up to 90 % of stroma thickness. Secondy, a second circular corneal cut — perpendicular to the surface, on distance from 150 to 300 mm from the first one, is performed so that the cuts intersected at a predict depth and the circular corneal flap with wedge-shaped profile was formed. After flap removal corneal wound is suturing with the single buried sutures 10‑0.Results. Operation and early post-op period were uneventful. MeanUCVA significantly improved from 0.07±0.03 to 0.26±0.13 to 3 months after surgery. Between 3 to 6 months after surgery, we observed the increasing of visual functions (like UCVA and BCVA). The improvement of BCVA was observed in 94.1 %, and in 76.5 % of cases the increase was more than 3 lines. The cylindrical component decreased from 9.1±3.8 to 5.4±2.5 D.Conclusions. FRAK is a new method for the treatment of stable advanced keratoconus, which helps to improve optical capacity of cornea, allows to save the patient’s own cornea, improves both UCVA and BCVA. Non-penetrating nature of the operation helps to minimize the complications. Femtosecond laser for corneal stroma resection provides high accuracy and predictability. Further research is needed to determine long-term outcomes. |
| format | Article |
| id | doaj-art-124ca5be241e45fa85032c3d821bf227 |
| institution | DOAJ |
| issn | 1816-5095 2500-0845 |
| language | Russian |
| publishDate | 2015-10-01 |
| publisher | Ophthalmology Publishing Group |
| record_format | Article |
| series | Oftalʹmologiâ |
| spelling | doaj-art-124ca5be241e45fa85032c3d821bf2272025-08-20T03:22:17ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452015-10-01123222910.18008/1816-5095-2015-3-22-29247Femtolaser refractive autokeratoplastic: first results and prospectsH. V. Sitnik0A. Yu. Slonimsky1Yu. B. Slonimsky2Belarusian Medical Academy of Post-Graduate Education, chair of ophthalmology, Brovki str. 3, build.3‑3, Minsk, Republic of Belarus, 220013Clinical hospital named after S. P. Botkin, Affiliate № 1 «Moscow Ophthalmology Hospital», Mamonovsky Lane, 7, Moscow, Russian Federation, 123001Russian Medical Academy of Postgraduate Education, chair of ophthalmology, Barricadnaya street, 2 / 1, Moscow, Russian Federation, 125993Purpose. Development of a new method of autokeratoplasty using of femtosecond laser in patients with advanced keratoconus and evaluation of early results of treatment.Patients and methods. 17 patients with advanced stable keratokonus were included in the study (15 men, 2 women) mean age 33±8.4 years old. Stage III of keratokonus was diagnosed in 3 eyes, stage IV was revealed in 14 eyes. Minimal corneal thickness was 381±33.82 μм, keratometric indices Ks 60.1±5.7 D, Kf 54.8±5.8 D, cylinder 9.1±3.8 D. Femtolaser-assisted refractive autokeratoplasty (FRAK) was performed with the use of «IntraLase 60 kHz». The idea of our method consists in performing of 2‑step resection of corneal stroma using femtosecond laser. Firstly, circular corneal cut should be made at an angle to the surface is fulfilled on distance 1.5‑2.0 mm from the limbus to a depth of up to 90 % of stroma thickness. Secondy, a second circular corneal cut — perpendicular to the surface, on distance from 150 to 300 mm from the first one, is performed so that the cuts intersected at a predict depth and the circular corneal flap with wedge-shaped profile was formed. After flap removal corneal wound is suturing with the single buried sutures 10‑0.Results. Operation and early post-op period were uneventful. MeanUCVA significantly improved from 0.07±0.03 to 0.26±0.13 to 3 months after surgery. Between 3 to 6 months after surgery, we observed the increasing of visual functions (like UCVA and BCVA). The improvement of BCVA was observed in 94.1 %, and in 76.5 % of cases the increase was more than 3 lines. The cylindrical component decreased from 9.1±3.8 to 5.4±2.5 D.Conclusions. FRAK is a new method for the treatment of stable advanced keratoconus, which helps to improve optical capacity of cornea, allows to save the patient’s own cornea, improves both UCVA and BCVA. Non-penetrating nature of the operation helps to minimize the complications. Femtosecond laser for corneal stroma resection provides high accuracy and predictability. Further research is needed to determine long-term outcomes.https://www.ophthalmojournal.com/opht/article/view/255keratoconuskeratoplastyautokeratoplastyfemtosecond laser |
| spellingShingle | H. V. Sitnik A. Yu. Slonimsky Yu. B. Slonimsky Femtolaser refractive autokeratoplastic: first results and prospects Oftalʹmologiâ keratoconus keratoplasty autokeratoplasty femtosecond laser |
| title | Femtolaser refractive autokeratoplastic: first results and prospects |
| title_full | Femtolaser refractive autokeratoplastic: first results and prospects |
| title_fullStr | Femtolaser refractive autokeratoplastic: first results and prospects |
| title_full_unstemmed | Femtolaser refractive autokeratoplastic: first results and prospects |
| title_short | Femtolaser refractive autokeratoplastic: first results and prospects |
| title_sort | femtolaser refractive autokeratoplastic first results and prospects |
| topic | keratoconus keratoplasty autokeratoplasty femtosecond laser |
| url | https://www.ophthalmojournal.com/opht/article/view/255 |
| work_keys_str_mv | AT hvsitnik femtolaserrefractiveautokeratoplasticfirstresultsandprospects AT ayuslonimsky femtolaserrefractiveautokeratoplasticfirstresultsandprospects AT yubslonimsky femtolaserrefractiveautokeratoplasticfirstresultsandprospects |