Purpose
The aim of this study was to compare the intraoperative data of femtosecond laser-assisted deep anterior lamellar keratoplasty (F-DALK) with those of manual trephine deep anterior lamellar keratoplasty (M-DALK).
Setting
The study was conducted in a single private centre (Alfat’h Eye Hospital).
Design
This is a nonrandomized comparative retrospective, single private centre clinical study.
Materials and Methods
The study was conducted between February 2013 and March 2016 on 40 eyes that underwent M-DALK and 24 eyes that underwent F-DALK, including moderate-to-advanced keratoconus (KC) intolerant to contact lenses, superficial corneal opacities or degenerations, and stromal corneal dystrophies (e.g. macular dystrophies, etc.) with best spectacle corrected visual acuity (BSCVA) less than or equal to 6/60 (0.1), and excluding those with KC (with acute hydrops or posthydrops scars), corneal opacities or corneal dystrophies involving the endothelium. The intraoperative data were retrieved and analysed.
Results
F-DALK had fewer intraoperative complications compared with M-DALK, such as the decentred cut, which was 0% in F-DALK versus 1/40 (2.5%) in M-DALK, with a statistically significant difference in the overall intraoperative complications between the two procedures (=0.004).
Conclusion
The F-DALK technique results in fewer intraoperative complications such as the inadvertent premature entry of the anterior chamber, a better centration of the cuts in patients with KC, and more success of the big bubble formation and thereby less conversion to penetrating keratoplasty or to manual dissection, which has a lower visual outcome.