Our objective was to evaluate the outcome of deep anterior lamellar keratoplasty (DALK) using femtosecond laser

This retrospective study included 23 eyes of 23 patients. Intraoperatively, a femtosecond laser assisted decagonal pattern DALK was performed. With a 27-gage needle, air was injected into stroma. Descemet baring was successfully achieved using the big bubble technique with precise depth. When microperforation occurred, the procedure completed with predescemet technique without complications.

The big bubble was achieved in 18 eyes. The mean age of the patients was 31 years (21 – 50 years). Data were available for 11 eyes at 12 month and other had less follow up time. The mean preoperative cylinder was -5.8 D (-1.75 to -10.5 D) that improved to -4 D (range -2.25 to -8D) postoperatively which was statistically significant (p=0.02). The mean UCVA (logMAR) was 0.88 ± 0.41 (0.1 to 2.0) with significant improvement to 0.64 ± 0.14 in 12 month period after the operation (range 0.48 – 1.0, p=0.02).

The method has advantages over conventional DALK with faster visual rehabilitation. The use of decagonal incision for DALK is more easy and precise to suture and reduces astigmatism.