Femtosecond laser-assisted intrastromal corneal ring segment implantation for high astigmatism correction after penetrating keratoplasty.

J Cataract Refract Surg. 2013 Sep 3;

Authors: Lisa C, García-Fernández M, Madrid-Costa D, Torquetti L, Merayo-Lloves J, Alfonso JF

Abstract

PURPOSE: To assess the visual and refractive outcomes of femtosecond laser-assisted implantation of Ferrara-type intrastromal corneal ring segments (ICRS) in post-penetrating keratoplasty (PKP) eyes.

SETTING: Instituto Oftalmológico Fernández-Vega, Oviedo, Spain.

DESIGN: Cohort study.

METHODS: Patients with previous PKP had ICRS implantation after femtosecond laser tunnel creation. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities and residual refractive errors were recorded before and 6 months after ICRS implantation. The power vector method was used to analyze refractive errors preoperatively and postoperatively.

RESULTS: This study enrolled 32 eyes of 30 patients. The mean UDVA (Snellen decimal) changed from 0.16 ± 0.15 (SD) preoperatively to 0.43 ± 0.28 postoperatively (P<.0001). Postoperatively, the UDVA was 20/40 or better in 40.6% of eyes. The mean CDVA was 0.67 ± 0.22 preoperatively and 0.80 ± 0.19 postoperatively (P<.0001). Postoperatively, the CDVA was better than 20/40 in 96.9% of eyes and 20/25 or better in 56.2% of eyes. By 6 months postoperatively, no eye had lost more than 2 lines of CDVA, 4 eyes lost 1 line, 6 eyes had no change, 9 eyes gained 1 line, and 13 eyes gained 2 or more lines. The safety index at 6 months was 1.20. The spherical equivalent and astigmatism components were significantly reduced after ICRS implantation (P<.04).

CONCLUSION: Intrastromal corneal ring segment implantation using the femtosecond laser may be a good alternative for high astigmatism correction in post-PKP eyes.

FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

PMID: 24011932 [PubMed – as supplied by publisher]