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Sutureless Femtosecond Laser-Assisted Anterior Lamellar Keratoplasty Using a Bioengineered Cornea as a Viable Alternative to Human Donor Transplantation for Superficial Corneal Opacities
Univ Tehran Med Sci, Iran.
Univ Tehran Med Sci, Iran.
Univ Tehran Med Sci, Iran.
Shahid Beheshti Univ Med Sci, Iran.
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2020 (English)In: Cornea, ISSN 0277-3740, E-ISSN 1536-4798, Vol. 39, no 9, p. 1184-1189Article in journal (Refereed) Published
Abstract [en]

Purpose: To evaluate the safety and efficacy of a bioengineered corneal implant using femtosecond laser-assisted anterior lamellar keratoplasty for superficial corneal opacities. Methods: Six eyes of 6 consecutive patients with superficial corneal stromal opacities involving <220 mu m owing to various pathologies were included in the study. Preoperatively, all patients underwent anterior segment optical coherence tomography (Visante; Carl Zeiss Meditec AG) to evaluate the depth of the corneal opacity. All patients underwent sutureless femtosecond laser-assisted anterior lamellar keratoplasty using a bioengineered collagen corneal implant (linkcor). Visual indices, refraction, and keratometry were evaluated preoperatively and 12 months postoperatively. Results: Corrected distance visual acuity improved significantly in all patients (P= 0.02). A significant decrease was seen in refractive astigmatism postoperatively (P= 0.04). Flat keratometry reduced significantly 12 months after the intervention (P= 0.04). No intraoperative or early postoperative complications were noticed. All implants were fully covered by healthy epithelium within a month after the surgery and remained clear at follow-up visits. The results of this procedure remained stable throughout the follow-up period. In 1 patient, mild inferior collagen melting and epithelial defect formation occurred at 1-year follow-up. Despite frequent topical corticosteroid therapy the melting progressed, the collagen tissue was removed and the patient was treated accordingly with good visual outcomes. Conclusions: Femtosecond laser-assisted anterior lamellar keratoplasty with bioengineered corneal (linkcor) implantation is an effective treatment for improving vision quality in anterior stromal opacities. This procedure reduces the need for human donor tissue and avoids human donor-related and suturing complications.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2020. Vol. 39, no 9, p. 1184-1189
Keywords [en]
anterior stromal opacities; femtosecond anterior lamellar keratoplasty; spectral domain optical coherence tomography; bioengineered corneal implants
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:liu:diva-170663DOI: 10.1097/ICO.0000000000002394ISI: 000571175100023PubMedID: 32558727OAI: oai:DiVA.org:liu-170663DiVA, id: diva2:1477698
Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2020-10-19

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Rafat, Mehrdad
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