Journal of Cataract & Refractive Surgery
Volume 35, Issue 5 , Pages 809-813, May 2009

Deep anterior lamellar keratoplasty performed with the femtosecond laser zigzag incision for the treatment of stromal corneal pathology and ectatic disease

  • Marjan Farid, MD

      Affiliations

    • Corresponding Author InformationCorresponding author: Marjan Farid, MD, Gavin Herbert Eye Institute at University of California, Irvine, 118 MedSurge I, Irvine, California 92697, USA.
  • ,
  • Roger F. Steinert, MD

From the Gavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, California, USA

Received 5 September 2008; received in revised form 16 January 2009; accepted 20 January 2009.

We describe a variation of the big-bubble deep anterior lamellar keratoplasty (DALK) technique using the femtosecond laser zigzag incision. This technique allows precise depth visualization for air-needle placement in the posterior stroma based on the lamellar and posterior laser cuts, thus minimizing the risk for perforation of Descemet membrane. The matching donor and host tissue zigzag cut allows more precise tissue apposition and greater surface area for healing. The angled anterior donor and host junction allows a smooth transition for improved visual outcomes. If the big-bubble– Descemet membrane dissection fails, the surgeon can convert to a full-thickness graft while retaining the benefits of the femtosecond laser incision.

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 Dr. Steinert is a consultant to Abbott Medical Optics. Neither author has a financial or proprietary interest in any material or method mentioned.

PII: S0886-3350(09)00143-6

doi:10.1016/j.jcrs.2009.01.012

Journal of Cataract & Refractive Surgery
Volume 35, Issue 5 , Pages 809-813, May 2009