Femtosecond Laser-Assisted Big Bubble for Deep Anterior Lamellar Keratoplasty

Author Type(s)

Student

Document Type

Article

Publication Date

1-2021

DOI

10.1097/j.jcrs.0000000000000400

Journal Title

Journal of Cataract and Refractive Surgery

Abstract

PURPOSE: To assess the utility of a femtosecond laser-assisted stromal channel to assist the creation of a big bubble (BB) for deep anterior lamellar keratoplasty (DALK) surgery in cadaveric corneas.

SETTING: L V Prasad Eye Institute, Hyderabad, India.

DESIGN: Experimental study.

METHODS: An attempt to create a BB was made on 10 donor pairs of human cadaveric corneoscleral tissues. The 20 corneas were split into 2 groups: Group A underwent femtosecond laser pretreatment and Group B had conventional manual deep lamellar technique. Laser pretreatment was performed using the VisuMax femtosecond laser system to create a stromal channel using the intracorneal ring segment treatment module for direct insertion of the 27-gauge air cannula for pneumodissection at a predetermined depth.

RESULTS: Of the 20 corneas studied, type 1 BB was achieved in 9 of 10 corneas in Group A and in 7 of 10 corneas in Group B. One cornea from Group A had a combined type 1 and 2 BB, whereas no BB was achieved in 1 cornea.

CONCLUSIONS: Creation of an intrastromal channel using a femtosecond laser at a predetermined depth seemed to be a promising option to increase the chances of achieving a BB when compared with the conventional air injection technique of BB DALK.

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