Premium
DALK Techniques from manual to femtolaser
Author(s) -
Nubile M.,
Salgari N.,
De Nicola C.,
Mastropasqua L.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0274
Subject(s) - corneal transplantation , dissection (medical) , fibrous joint , femtosecond , lamellar structure , medicine , corneal disease , ophthalmology , surgery , cornea , laser , biomedical engineering , materials science , optics , physics , composite material
Summary The continuous evolution of corneal transplantation has recently demonstrated that the surgical approach based on selective lamellar keratoplasty represents the gold‐standard for the treatment of corneal disease. The replacement of the diseased corneal layers with deep anterior lamellar (DALK) or endothelial keratoplasty clearly gives advantages to patients in terms of safety and outcomes. The introduction of femtosecond laser technology (FSL) into the clinical practice, after the wide use for refractive surgical corneal procedures, allowed a significant refinement in terms of precision and customization of both penetrating and lamellar keratoplasty (ALK and DALK). The main advantages of using FSLs are represented by the possibility of performing complex‐shaped trephination in both donor and recipient tissues (for example top‐hat or zig‐zag cut profiles) and the great precision of lamellar dissection. The concept of reducing or avoiding sutures (femtosecond laser suture‐less ALK) is still debated. However to date cut quality and interface smoothness represents critical points to be improved.