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Ultrathin DSAEK: The Future of Endothelial Keratoplasty?

Speakers: Jacqueline Beltz MBBS FRANZCO

Tags: DSAEK, 2013, Ultrathin DSAEK, Annual Meeting, Endothelial Keratoplasty, ASCRS Course 21-403: Ultrathin DSAEK: The Future of Endothelial Keratoplasty?, ASCRS MediaCenter

Course will present a technique of endothelial keratoplasty aimed at improving visual results while maintaining technical simplicity. Advantages and disadvantages of ultrathin DSAEK and use in challenging cases will be presented. Videos will illustrate preparation of ultrathin grafts and technique for delivery, as well as 2-year results and complications.

Femtosecond Laser Microbubble Technique for Deep Anterior Lamellar Dissection

Speakers: Roger F. Steinert MD

Tags: ASCRS Innovators Session, 2013, deep lamellar keratoplasty, DALK, femtosecond laser, Annual Meeting, ASCRS MediaCenter

Purpose: To develop a method for smooth deep lamellar dissection of the cornea with the femtosecond laser for anterior lamellar keratoplasty and for donor preparation in thin donor endothelial keratoplasty. Methods: Parameters for the iFS IntraLase (Abbott Medical Optics) femtosecond laser were modified to create a smooth lamellar dissection. Gross inspection and electron microscopy of the bed and the endothelium was performed. Surgical cases were then performed. Results: The successful development of a smooth deep lamellar bed was achieved with a technique of widely spaced, low energy pulses and a multi-pass technique combining both raster and spiral patterns. The side-cut is performed only as the last step. Anatomical preservation of the endothelium correlated with good surgical results. Conclusion: A multi-pass femtosecond laser technique can successfully create a smooth bed in the deep cornea. Multiple small microbubbles appear to facilitate the development of the lamellar bed. This technique may be useful in preparation of thin stroma donor tissue for endothelial keratoplasty as well as for anterior lamellar surgery in keratoconus and other anterior corneal pathology.