Femtosecond laser-assisted deep anterior lamellar keratoplasty in phototherapeutic keratectomy versus the big-bubble technique in keratoconus

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dc.contributor.authorMacedo, Jarbas Pereira de [UNIFESP]
dc.contributor.authorOliveira, Lauro Augusto de [UNIFESP]
dc.contributor.authorHirai, Flávio Eduardo [UNIFESP]
dc.contributor.authorSousa, Luciene Barbosa de [UNIFESP]
dc.date.accessioned2018-07-26T12:18:47Z
dc.date.available2018-07-26T12:18:47Z
dc.date.issued2018
dc.description.abstractAIM: To compare the functional and anatomic results of femtosecond laser (FSL)-assisted deep anterior lamellar keratoplasty (DALK) associated with phototherapeutic keratectomy (PTK) and FSL-assisted DALK performed using the big-bubble technique in keratoconus. METHODS: During the first phase of the study, an electron microscopy histopathology pilot study was conducted that included four unsuitable donor corneas divided into two groups: in FSL group, FSL lamellar cuts were performed on two corneas and in FSL+ PTK group, PTK was performed at the stromal beds of two corneas after FSL lamellar cuts were made. During the second phase of the study, a randomized clinical trial was conducted that included two treatment groups of patients with keratoconus: group 1 (n= 14 eyes) underwent FSL-assisted DALK associated with PTK and group 2 (n= 12 eyes) underwent FSL-assisted DALK associated with the big-bubble technique. The main outcome measures were the postoperative visual acuity (VA) and optical coherence tomography (OCT) measurements, confocal microscopic findings, and contrast sensitivity. RESULTS: In the pilot study, histopathology showed a more regular stromal bed in the FSL+ PTK group. In the clinical trial, group 1 had significantly worse best spectacle-corrected VA and contrast sensitivity (P< 0.05 for both comparisons). The residual stromal bed measured by OCT was significantly (P< 0.05) thicker in group 1. Confocal microscopy detected opacities only at the donor-receptor interface in group 1. CONCLUSION: Patients with keratoconus treated with FSL-assisted DALK performed using the big-bubble technique fare better than treated with FSL-assisted DALK associated with PTK.en
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Dept Ophthalmol & Visual Sci, BR-04039032 Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Dept Ophthalmol & Visual Sci, BR-04039032 Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent807-812
dc.identifierhttp://dx.doi.org/10.18240/ijo.2018.05.15
dc.identifier.citationInternational Journal Of Ophthalmology. Xi An, v. 11, n. 5, p. 807-812, 2018.
dc.identifier.doi10.18240/ijo.2018.05.15
dc.identifier.fileWOS000433246500015.pdf
dc.identifier.issn2222-3959
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/46034
dc.identifier.wosWOS:000433246500015
dc.language.isoeng
dc.publisherIjo Press
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectdeep anterior lamellar keratoplastyen
dc.subjectphotother-apeutic keratectomyen
dc.subjectbig-bubble techniqueen
dc.subjectkeratoconusen
dc.titleFemtosecond laser-assisted deep anterior lamellar keratoplasty in phototherapeutic keratectomy versus the big-bubble technique in keratoconusen
dc.typeinfo:eu-repo/semantics/article
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