Because the Femtosecond laser is able to cut corneal tissue at precise depths and in a variety of patterns, it has brought significant improvements to the outcomes of corneal transplantation eye surgery since its introduction. Penetrating keratoplasty (PK), one of the more established techniques, has benefited greatly from the technology.
Femtocecond laser technology also enables surgeons to divide donated corneal tissue into anterior and posterior lamellar segments for use in partial thickness and Descemet-stripping endothelial keratoplasty (DSAEK).
Anterior Lamellar Keratoplasty (ALK) is a partial thickness grapht utilizing Femtosecond laser technology to selectively remove the diseased anterior layers of the cornea and preserves the two healthy innermost layers, the endothelium and Descemet’s membrane. As the inner layers are retained the body does not recognize the donor tissue, hence there is less risk of rejection. This technique is typically used for the treatment of Keratoconus.
DSAEK is a new corneal graft transplant technique where the unhealthy, diseased, posterior portion of a patient’s cornea is removed and replaced with healthy donor tissue obtained from the eye bank. Unlike conventional corneal transplant surgery known as penetrating keratoplasty (PK), the DSAEK procedure utilises a much smaller surgical incision and requires fewer corneal sutures. This usually results in more rapid visual rehabilitation for the DSAEK patient and also better post-operative visual acuity.
DSAEK is indicated for those patients who have corneal pathology located on the posterior aspect of their cornea known as the endothelial layer. This most commonly occurs in patients who have sustained trauma to the endothelial layer during complicated cataract surgery or patients who have an inherited disease of the corneal endothelium known as Fuchs’ Endothelial Dystrophy. It is also indicated for patients with endothelial rejection and bullous keratopathy.