Clinical Observation On The Safety And Availability Of Modified Femtosecond Laser Assisted Descemet’s Stripping Endothelial Keratoplasty In The Treatment Of Corneal Endothelial Dysfunction

Objective:To evaluate the safety and availability of modified femtosecond laser assisted descemet’s stripping endothelial keratoplasty in the treatment of corneal endothelial dysfunction.Methods:Retrospective analysis of 72 cases of 74 eyes who underwent modified femtosecond laser assisted descemet’s stripping endothelial keratoplasty with corneal endothelial dysfunction corneal endothelial dysfunction in Shandong eye hospital from May2013 to May 2017.There were 38 males and 38(51.4%)eyes,34 women in 36(48.6%)eyes,and age(58.16±15.44)years(22-85 years old).All operations were performed by 1surgeons.The modified technology:graft side cut by femtosecond laser and the cutting diameter is 8.2-8.4mm,the reserved thickness is 120um,the side cutting depth=donor corneal thickness-thickness of reserved graft.The upper cornea was stripped by manual,endothelium grafts with thin slice of stroma cut off buy corneal scissors.48 eyes(64.7%)underwent modified femtosecond laser assisted descemet’s stripping endothelial keratoplasty,21(28.4%)eyes underwent modified-femtosecond laser assisted descemet’s stripping endothelial keratoplasty combined with phacoemulsification combined and IOL implantation,5 eyes underwent modified femtosecond laser assisted descemet’s stripping endothelial keratoplasty combined with other surgical procedures,setting edge cut depth to reserve the thickness of120um graft.All patients were followed up for 3-6 months.The visual acuity,intraocular pressure(IOP),the loss of corneal endothelium,the total thickness of the central graft and plant bed,the thickness of the central graft,rejection rate,and the complications after the operation were observed.Results:All the operations were performed by 1 surgeons successfully without intraoperative complications.At 1 months after operation,the endothelial cell count was 1980±553/mm~2,and the endothelial loss rate was 16.0%.The postoperative visual acuity of the patients was higher than that before the operation.The total thickness of the central cornea was604±61.7um(440-685um)after the operation 6 months,which was significantly lower than preoperative 797.01±159.7um(493-1230um).Differences are statistically significant(t=5.58,P=0.00).The thickness of the central corneal graft was 104±46.1um(56-148um)6months after the operation.1 months after the operation the endothelium was 1980±553/mm~2,and the loss rate of endothelium was(16%).During the follow-up period 10 eyes(13.5%)occurred graft dislocation,and grat attached well by reinjection of gas.3 eyes(4.1%)had graft rejection and turned well by antirejection therapy,there was no graft failure 4 eyes(5.4%)had postoperative high intraocular pressure,drug control well.1 eyes(1.4%)occurred graft failure,and 1 eyes(1.4%)had pupillary block,and turned well by peripheral iridectomy.Conclusion:A modified-femtosecond laser assisted descemet’s stripping endothelial keratoplasty can obtain thinner corneal endothelial grafts with corneal stroma.This method is a safe and availability method for the treatment of corneal endothelial dysfunction with fewer postoperative complications and the receptor cornea recoved transparency.