Won Moon Seo; Hong Kyun Kim

doi:10.3341/jkos.2008.49.1.40

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Seo and Kim: Early Result of Femtosecond Laser Assisted Descemet’s Membrane Stripping Endothelial Keratoplasty

Original Article

J Korean Ophthalmol Soc 2008;49(1):40-47.

Published online: 3 August 2008

DOI: https://doi.org/10.3341/jkos.2008.49.1.40

Early Result of Femtosecond Laser Assisted Descemet’s Membrane Stripping Endothelial Keratoplasty

Won Moon Seo, M.D., Hong Kyun Kim, M.D.

Department of Ophthalmology, Kyungpook National University College of Medicine, Daegu, Korea

Address reprint requests to Hong Kyun Kim, M.D. Department of Ophthalmology, Kyungpook National University College of Medicine #50 2ga Samduk-dong, Jung-gu, Daegu 700-721, Korea Tel: 82-53-420-5816, Fax: 82-53-426-6552, E-mail: itkim@knu.ac.kr

Received 9 May 2007 Accepted 4 September 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the first cases of Descemet’s stripping endothelial keratoplasty in patients with pseudophakic bullous keratopathy.

Methods

Four eyes of 4 patients who had corneal edema from pseudophakic bullous keratopathy were enrolled. We performed femtosecond laser-assisted Descemet’s membrane stripping endothelial keratoplasty (DSEK). We then evaluated preoperative and postoperative best corrected visual acuities (BCVA), manifest refractions, keratometries, topographic astigmatisms, corneal pachymetries, and perioperative complications.

Results

The mean follow-up period was 6 months. Three of the four eyes had successful transplantations. Since the operation, these patients have shown improvement in visual acuity and have recovered from corneal edema. However, in one patient, the transplanted corneal disc was dislocated, and he needed an additional procedure for reattachment.

Conclusions

The lack of corneal incisions or sutures in DSEK was helpful for maintaining corneal curvature and globe integrity after surgery. The surgery resulted in rapid visual rehabilitation and prevented suture-induced complications. With a femtosecond laser, we could prepare donor cornea in an automated and standardized fashion. In conclusion, femtosecond laser-assisted DSEK has significant advantages over standard penetrating keratoplasty for patients with pseudophakic bullous keratopathy.

Keywords: Descemet’s membrane stripping endothelial keratoplasty, Femtosecond laser

References

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Figure 1.

Each line represents the changes in best corrected visual acuity for a single patient.

Figure 2.

Preoperative photo of patient 1 showing corneal edema and haze from pseudophakic bullous keratopathy. Intraocular lens haptic (arrow) is protruded through the previous iridectomy site.

Figure 3.

Slitlamp photograph of DSEK graft 2 weeks after surgery. Note the clear central cornea with clear interface and smooth surface. The edge of the donor tissue is illuminated (arrow).