Preliminary Results of Femtosecond Laser-Assisted Descemet Stripping Endothelial Keratoplasty for Bullous Keratopathy

Objective To evaluate the preliminary results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK) for the treatment of bullous keratopathy.Methods In the nonrandomized,prospective,consecutive case series,7 eyes with bullous keratopathy induced by cataract surgery received FS-DSEK surgery between September and December 2013.Standard Descemet stripping endothelial keratoplasty procedure was performed.The Descemet membrane and abnormal endothelial layer were stripped from the central recipient posterior surface in a diameter of 7.75 mm.The graft was fixed to the edge of recipient cornea with one single stitch.The donor lenticule was produced by Intralase 150 femtosecond laser with a diameter of 7.75 mm.The adherence of donor lenticule to the recipient posterior stroma and postoperative donor lenticule dislocation were monitored in the early stage after surgery.Best spectacle-corrected visual acuity,refraction,endothelial cell density and thickness of grafts were measured preoperatively,and at 1 week,1,3,6 and 12 months after FS-DSEK.Results Two eyes had graft dislocation,with a gap between the graft and recipent posterior stroma at 2 days after surgery.The grafts were repositioned after bubbles were added into the anterior chamber.All grafts were well adherent to the recipent posterior stromal surface at 1 week postoperatively.One graft failed at 3 months postoperatively,and penetrating keratoplasty was performed.At 12 months,the best spectacle-corrected visual acuity was 0.04 to 0.7,the mean endothelial cell density was (1 698.0±251.8) cells/mm2,and the mean thickness of grafts was (124.2 ± 11.4) μm.Conclusion Femtosecond laser-assisted Descemet stripping endothelial keratoplasty was effective in treating bullous keratopathy.Stitching the graft to the recipent cornea can prevent postoperative graft dislocation effectively.