Experience of femtosecond laser support in the treatment of progressive keratokonus
E.G. SOLODKOVA, V.P. FOKIN
Volgograd branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 80 Zemlyachki Str., Volgograd, Russian Federation, 400138
Solodkova E.G. ― Cand. Med. Sc., Head of the Department of Refraction Abnormalities Correction, ophthalmosurgeon, e-mail: mntk@isee.ru
Fokin V.P. ― D. Med. Sc., Professor, Director, e-mail: mntk@isee.ru
The analysis is carried out of the results of surgical treatment of progressive keratoconus at the early and expressed stages based on femtosecond technologies. The first group consisted of 10 patients (10 eyes) with stage 1-2 of keratoconus, operated by the method of corneal collagen crosslinking with femtosecond formation of the intrastromal pocket to administer the photosensitizer and local ultraviolet irradiation. The second group consisted of patients with progressive keratoconus of the 3rd stage (24 eyes), who were operated with the formation of an intra-stromal tunnel for the introduction of corneal segments. In all cases, a significant increase in visual acuity (NCD and IHEC) was noted, as well as a decrease in keratometric parameters, a decrease in elevation of both the anterior and posterior corneal surfaces.
Key words: keratoconus, intralamellar keratoplasty, implantation of corneal segments, femtosecond laser, crosslinked corneal collagen.
REFERENCES
- Rabinowitz Y.S. Keratokonus. Survey of ophthalmology, 1998, no. 42, rr. 297-319.
- Colin J., Cochener B., Savary G., Malet F. Correcting keratoconus with intrastromal rings. J. Cataract Refract Surg, 2000, no. 26, rr. 1117-1122.
- Colin J., Malet F.J. Intacs for the correction of keratoconus: two-year follow-up. J. Cataract. Refract. Surg, 2007, vol. 33, no. 1, pp. 69-74.
- Kanellopoulos A.J., Pe L.H., Perry H.D. et al. Modified intracorneal ring segment implantations (INTACS) for the management of moderate to advanced keratoconus: efficacy and complications. Cornea, 2006, vol. 25, no. 1, pp. 29-33.
- Wollensak G., Spoerl E., Seiler T. Riboflavin/ultrafiolet-A-induced collagen cross-linking for the treatment of keratoconus. Am. J. Ophthalmol, 2003, vol. 135, no. 5, rr. 620-627.
- Pinelli R. C3-R treatment opens new frontiers for keratoconus and corneal ectasia. Eyeword, 2007, no. 34, rr. 36-39.
- Izmaylova S.B., Malyugin B.E., Pronkina S.A., Merzlov D.E. et al. Tactics of treatment and outcomes of complications of implantation of corneal segments with keratectasias of different genesis. Oftal’mokhirurgiya, 2014, no. 2, pp. 16-23 (in Russ.).
- Malyugin B.E., Izmaylova S.B., Avramenko S.A., Merzlov D.E. Treatment of paracentral keratectases of various genesis by the method of intrastromal keratoplasty with implantation of the corneal segment into the zone of greatest ectasia. Oftal’mokhirurgiya, 2011, no. 4, pp. 16-22 (in Russ.).
- Zotov V.V., Sal’nikov V.V., Pozdeeva N.A. Changes in the ultrastructure of the corneal stroma after crossing. Prakticheskaya meditsina, 2012, vol. 1, no. 4, pp. 95-96 (in Russ.).
- Kostenev S.V., Chernykh V.V. Femtosekundnaya lazernaya khirurgiya. Printsipy i primenenie v oftal’mologii [Femtosecond laser surgery. Principles and application in ophthalmology]. Novosibirsk: Nauka, 2012. 141 p.
- Zotov V.V., Pashtaev N.P., Larionov E.V., Pozdeeva N.A., Anisimov S.I. Comparative histochemical study of the structure of normal collagen and keratoconus cornea during the modeling of crosslinking with the use of a femtolaser in vitro. Kataraktal’naya i refraktsionnaya khirurgiya, 2013, vol. 13, no. 2, pp. 32-36 (in Russ.).
- Kostenev S.V., Chernykh V.V. Comparative clinico-functional analysis of intrastromal corneal segment implantation using a traditional and improved method using a femtosecond laser. Prakticheskaya meditsina, 2013, no. 1-3, pp. 71-74 (in Russ.).
- Maslova N.A. Femtolazernaya intrastromal’naya keratoplastika s implantatsiey rogovichnykh segmentov v lechenii patsientov s keratokonusom: avtoref. diss. … kand. med. nauk [Femtolaser intrastromal keratoplasty with implantation of corneal segments in the treatment of patients with keratoconus. Synopsis of dis. PhD med. sci]. Moscow, 2012. 115 p.
- Pashtaev N.P., Zotov V.V. Comparative analysis of the long-term results of standard and local femtocrosline in patients with progressive keratoconus. Vestnik OGU, 2014, no. 12, pp. 248-251 (in Russ.).
- Amsler M. La notion du keratocone. Bull. Soc. franc. Ophthalmol, 1951, vol. 64, no. 2, pp. 272-275.
- Jalbert I. et al. In vivo corneal microscopy of human cornea. Brit. J. Ophthalmol, 2003, vol. 87, no. 2, pp. 225-236.