Deep anterior lamellar keratoplasty with femtosecond-laser zigzag incisions

We describe a technique that uses IntraLase–created zigzag incisions for deep anterior lamellar keratoplasty. In this technique, the laser creates a precise incision that extends to within 70 μm of the recipient Descemet membrane. The deep incision minimizes air escape into the peripheral cornea during big-bubble formation. In cases that require hand dissection, the deep incision provides a reference for gauging the dissection depth. The angled incision edge facilitates final stromal excision with scissors. Compared with standard vertical incisions, the zigzag incision provides an interlocking wound configuration and facilitates matching the donor and recipient anterior surfaces.