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Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Femtosecond Laser-Assisted Membranectomy of Retained Host's Descemet's Membrane Postpenetrating Keratoplasty
Zuheer Meeraalam1, Enrique Suarez1, Mohammad Al-Amro1
1Department of Cornea and Refractive Surgery, King Khalid Eye Specialist Hospital, Riyadh, KSA.
Abstract:
We report the two cases in which femtosecond laser (FSL) technology used to manage visually significant retained host's Descemet's membrane (RHDM) after penetrating keratoplasty (PKP). FSL-assisted descemetorhexis was done first, then membrane removal with intraocular forceps. Both patients had advanced keratoconus and were managed with PKP. In the first patient, FSL descemetorhexis of RHDM was incomplete. It was augmented manually, and then, the removal of the retained membrane was done with an intraocular forceps, whereas, a complete and central 5.5 mm FSL descemetorhexis was created in the second case. Then, it was pulled out with intraocular forceps. Postoperatively, the best-corrected visual acuity was 20/40, with an intraocular pressure (IOP) of 18 mmHg. In the second case, best-corrected visual acuity and IOP were 20/70 and 16 mmHg, respectively. In conclusion, FSL technology can be an alternative to manual or neodymiumdoped yttrium - aluminum garnet membranotomy for the management of RHDM after PKP.
Insights
Femtosecond laser (FSL) technology offers a new approach for managing retained host
Area of Science:
- Ophthalmology
- Surgical Technology
Background:
- Retained host's Descemet's membrane (RHDM) can cause visual impairment after penetrating keratoplasty (PKP).
- Current management options for RHDM include manual or laser membranotomy.
Observation:
- Two cases of visually significant RHDM after PKP in patients with advanced keratoconus are presented.
- Femtosecond laser (FSL)-assisted descemetorhexis was utilized for RHDM management, followed by membrane removal with intraocular forceps.
Findings:
- In one case, FSL descemetorhexis was incomplete and required manual augmentation. The other case achieved complete FSL descemetorhexis.
- Postoperative visual acuity was 20/40 and 20/70 in the respective cases, with intraocular pressures within normal limits.
Implications:
- FSL technology presents a viable alternative for RHDM management post-PKP.
- This technique may offer improved precision and safety compared to traditional methods.
