• Comprehensive Ophthalmology

    This retrospective study found that keratoconus patients who underwent femtosecond laser-enabled keratoplasty (FLEK) with a zig-zag incision configuration had faster visual recovery than those who underwent conventional PKP.

    The authors reviewed the charts of 56 keratoconus patients (66 eyes) who underwent FLEK with a zig-zag incision configuration and compared the results with those of 60 patients (71 eyes) who had traditional blade mechanical trephination PKP.

    At three months postop, BSCVA and topographic astigmatism were significantly better in the FLEK group compared with the PKP group. A BSCVA of 20/40 or greater was obtained in 28 cases (42.42 percent) in the FLEK group, compared with 9.7 percent of cases in the PKP group. Postoperative complications noted were not different between the two groups. There were no cases of wound dehiscence after suture removal and no cases of postoperative graft rejection.

    Six months after surgery, the FLEK group showed better values for all the parameters studied, but the difference between the groups did not reach statistical significance.

    The authors write that FLEK is their procedure of choice in patients with advanced keratoconus whose only option is a corneal transplant due to: faster visual rehabilitation and better long-term visual acuity; earlier suture removal; a biomechanically stronger corneal wound; safety; rapidity of the procedure; and less endothelial cell loss. However, a randomized, prospective clinical trial is needed to further clarify the true benefits of the FLEK over conventional PKP.