Zig Zag versus Top Hat configuration in IntraLase-enabled penetrating keratoplasty

Aim To compare the outcomes with IntraLase-enabled keratoplasty using (IEK) Top Hat (TH) versus Zig Zag (ZZ) configuration. Methods Retrospective comparative series of 24 eyes that underwent TH and 10 eyes that underwent ZZ IEK. Results There were no significant differences in LogMar Best-spectacle corrected visual acuity (TH- IEK=0.3; ZZ-IEK=0.18, p=0.18), spherical equivalent (TH-IEK=−3.55±3.7 dioptres (D); ZZ-IEK=−2.69±4.85 D, p=0.60), manifest cylinder (TH- IEK=3.79±2.43 D; ZZ- IEK=4.61±3.29 D, p=0.45), topographic astigmatism (TH-IEK=3.67±2.34 D; ZZ-IEK=4.26±1.1 D, p=0.63), total higher-order aberrations (TH- IEK=8.26±3.53; ZZ-IEK=8.1±4.71, P=0.92), endothelial cell density change from baseline (TH- IEK= −41.55%±15.86; ZZ-IEK=−25.45%±30.66, p=0.22) or time to suture removal in months (TH- IEK=7.48±4.07; ZZ- IEK=6.93±2.71, p=0.75). There was no difference in requirements for astigmatic keratectomy (TH-IEK=54.2%±13; ZZ-IEK=50%±5, OR=1.18) or complications (TH-IEK=25%±6; ZZ-IEK=30%±3, OR=0.78). Conclusions TH-IEK and ZZ-IEK have comparable visual and refractive outcomes, wound healing and endothelial cell counts at 1-year.

[1]  H. Dua,et al.  Management of post-keratoplasty astigmatism. , 2012, Journal of cataract and refractive surgery.

[2]  R. Steinert,et al.  Comparison of penetrating keratoplasty performed with a femtosecond laser zig-zag incision versus conventional blade trephination. , 2009, Ophthalmology.

[3]  I. Bahar,et al.  Femtosecond laser versus manual dissection for top hat penetrating keratoplasty , 2008, British Journal of Ophthalmology.

[4]  E. Pels,et al.  Femtosecond laser-assisted inverted mushroom keratoplasty. , 2008, Cornea.

[5]  F. Price,et al.  Femtosecond laser shaped penetrating keratoplasty: one-year results utilizing a top-hat configuration. , 2008, American journal of ophthalmology.

[6]  I. Bahar,et al.  Femtosecond Laser-assisted Penetrating Keratoplasty: Stability Evaluation of Different Wound Configurations , 2008, Cornea.

[7]  Matthew Kim,et al.  Results of penetrating keratoplasty performed with a femtosecond laser zigzag incision initial report. , 2007, Ophthalmology.

[8]  L. Buratto,et al.  The use of the femtosecond laser in penetrating keratoplasty. , 2007, American journal of ophthalmology.

[9]  R. Chuck,et al.  Top Hat Wound Configuration for Penetrating Keratoplasty Using the Femtosecond Laser: A Laboratory Model , 2006, Cornea.

[10]  Massimo Busin,et al.  Microkeratome-assisted mushroom keratoplasty with minimal endothelial replacement. , 2005, American journal of ophthalmology.

[11]  J. Jonas,et al.  Femtosecond laser penetrating keratoplasty with conical incisions and positional spikes. , 2004, Journal of refractive surgery.

[12]  Robert W. Thompson,et al.  Long-term graft survival after penetrating keratoplasty. , 2003, Ophthalmology.

[13]  M. Busin.  A new lamellar wound configuration for penetrating keratoplasty surgery. , 2003, Archives of ophthalmology.

[14]  D. Hodge,et al.  Ten-year postoperative results of penetrating keratoplasty. , 1998, Ophthalmology.

[15]  F. Price,et al.  Management of postkeratoplasty astigmatism. , 1998, Current opinion in ophthalmology.

[16]  J. Polansky,et al.  The TIGR gene, pathogenic mechanisms, and other recent advances in glaucoma genetics , 1998, Current opinion in ophthalmology.

[17]  D. Schanzlin,et al.  Visual outcome after penetrating keratoplasty with double continuous or combined interrupted and continuous suture wound closure. , 1992, American journal of ophthalmology.

[18]  R. Marks,et al.  Progression of visual acuity after penetrating keratoplasty. , 1991, Ophthalmology.

[19]  D. Musch,et al.  Corneal astigmatism after penetrating keratoplasty. The role of suture technique. , 1989, Ophthalmology.

[20]  D. Musch,et al.  The effect of removing running sutures on astigmatism after penetrating keratoplasty. , 1988, Archives of ophthalmology.

[21]  P S Binder,et al.  Visual acuity, refractive error, and astigmatism following corneal transplantation for pseudophakic bullous keratopathy. , 1985, Ophthalmology.

[22]  W. Bourne,et al.  Results of penetrating keratoplasty using a double running suture technique. , 1981, Archives of ophthalmology.

[23]  E. Perlman,et al.  An analysis and interpretation of refractive errors after penetrating keratoplasty. , 1981, Ophthalmology.