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Correction of postkeratoplastic astigmatism by intrastromal corneal segments implantation using a femtosecond laser

https://doi.org/10.29413/ABS.2021-6.6-1.6

Abstract

Background. After penetrating keratoplasty, mild to high induced corneal astigmatism was observed in each case. The existing choice of correction of postkeratoplastic astigmatism is aimed at fi nding an individual approach in order to compensate for it and not weaken the biomechanical properties of the corneal graft.
The aim: to analyze the clinical, functional, and morphological results of postkeratoplastic astigmatism correction by implantation of intrastromal corneal segments using a femtosecond laser.
Methods. 22 patients were examined before and 1 year after surgery. The operation was performed under local anesthesia: stage I – an intrastromal tunnel was formed using a femtosecond laser “Femto Visum” 1 MHz (Optosystems, Russia); stage II – the intrastromal corneal segments were implanted. The results were assessed using standard and special research methods using optical coherence tomography Visante OCT (Zeiss, Germany), keratotopography (Tomey-5, Japan), optical corneal analyzer ORA (Reichert, USA), laser tindalemetry FC-2000 (Kowa, Japan) and confocal microscope Confoscan-4 (Nidek, Japan).
Results. Before the operation, uncorrected visual acuity averaged 0.09 ± 0.05, after a year – 0.50 ± 0.16; best corrected visual acuity – 0.30 ± 0.12 and 0.60 ± 0.05 respectively; cylindrical component of refraction – –10.29 ± 3.12 and –2.20 ± 0.64 D respectively; mean keratometry value – 43.59 ± 2.14 and 38.56 ± 1.75 D respectively; corneal hysteresis – 7.92 ± 1.22 and 8.95 ± 1.05 mm Hg respectively; corneal resistance factor – 7.01 ± 1.81 and 8.44 ± 1.44 mm Hg respectively; protein fl ux in the moisture of the anterior chamber – 2.97 ± 0.28 and 3.04 ± 0.24 f/ms respectively; endothelial cell density – 1521 ± 327 and 1475 ± 419 cells/mm2 respectively.
Conclusion. Intrastromal corneal segments implantation into a corneal graft using a femtosecond laser has efficiency and safety method in correcting postkeratoplastic astigmatism.

About the Authors

N. A. Pozdeyeva
Cheboksary Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

 Dr. Sc. (Med.), Docent, Director

 Traktorostroiteley ave. 10, Cheboksary 428028, Russian Federation 



M. V. Sinitsyn
Cheboksary Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

 Cand. Sc. (Med.), Head of the Children’s Unit 

 Traktorostroiteley ave. 10, Cheboksary 428028, Russian Federation 



A. E. Terentieva
Cheboksary Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

 Ophthalmologist at the Laser Refractive Surgery Unit 

 Traktorostroiteley ave. 10, Cheboksary 428028, Russian Federation 



O. V. Shlenskaya
Cheboksary Branch of S.N. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation

 Cand. Sc. (Med.), Head of the Diagnostic Department 

 Traktorostroiteley ave. 10, Cheboksary 428028, Russian Federation 



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Review

For citations:


Pozdeyeva N.A., Sinitsyn M.V., Terentieva A.E., Shlenskaya O.V. Correction of postkeratoplastic astigmatism by intrastromal corneal segments implantation using a femtosecond laser. Acta Biomedica Scientifica. 2021;6(6-1):48-55. (In Russ.) https://doi.org/10.29413/ABS.2021-6.6-1.6

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