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Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty
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| Zeitschriftentitel: | BMJ Open Ophthalmology |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | BMJ Open Ophthalmology, 3, 2018, 1, S. e000148 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
BMJ
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| Schlagwörter: |
| author_facet |
Pilger, Daniel von Sonnleithner, Christoph Bertelmann, Eckart Maier, Anna-Karina B Joussen, Antonia M Torun, Necip Pilger, Daniel von Sonnleithner, Christoph Bertelmann, Eckart Maier, Anna-Karina B Joussen, Antonia M Torun, Necip |
|---|---|
| author |
Pilger, Daniel von Sonnleithner, Christoph Bertelmann, Eckart Maier, Anna-Karina B Joussen, Antonia M Torun, Necip |
| spellingShingle |
Pilger, Daniel von Sonnleithner, Christoph Bertelmann, Eckart Maier, Anna-Karina B Joussen, Antonia M Torun, Necip BMJ Open Ophthalmology Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty Ophthalmology |
| author_sort |
pilger, daniel |
| spelling |
Pilger, Daniel von Sonnleithner, Christoph Bertelmann, Eckart Maier, Anna-Karina B Joussen, Antonia M Torun, Necip 2397-3269 BMJ Ophthalmology http://dx.doi.org/10.1136/bmjophth-2018-000148 <jats:sec><jats:title>Objective</jats:title><jats:p>Descemet membrane endothelial keratoplasty (DMEK) remains a challenging technique. We compare the precision of femtosecond laser-assisted DMEK to manual DMEK.</jats:p></jats:sec><jats:sec><jats:title>Methods and Analysis</jats:title><jats:p>A manual descemetorhexis (DR) of 8 mm diameter was compared with a femtosecond laser-assisted DR of the same diameter (femto-DR) in 22 pseudophakic patients requiring DMEK. We used OCT images with a centred xy-diagram to measure the postoperative precision of the DR and the amount of endothelial denuded area. Endothelial cell loss (ECL) and best corrected visual acuity were measured 3 months after surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the manual group, the median error of the DR was 7% (range 3%–16%) in the x-diameter and 8% (range 2%–17%) in the y-diameter. In the femto group, the median error in the respective x and y-diameters was 1% (range 0.4%–3%) and 1% (range 0.006%–2.5%), smaller than in the manual group (p=0.001). Endothelial denuded areas were larger in the manual group (11.6 mm<jats:sup>2</jats:sup>, range 7.6–18 mm<jats:sup>2</jats:sup>) than in the femto group (2.5 mm<jats:sup>2</jats:sup>, range 1.2–5.9 mm<jats:sup>2</jats:sup>) (p<0.001). The ECL was 21% (range 5%–78%) in the manual DR and 17% (range 6%–38%) in the femto-DR group (p=0.351). The median visual acuity increased from 0.4 logMAR (range 0.6–0.4 logMAR) in both groups to 0.1 logMAR (range 0.4–0 logMAR) in the manual group and to 0.1 logMAR (range 0.3–0 logMAR) in the femto group (p=0.461). Three rebubblings were required in the manual group, whereas the femto group required only one.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The higher precision of the femto-DR bears the potential to improve DMEK surgery.</jats:p></jats:sec> Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty BMJ Open Ophthalmology |
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| title |
Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_unstemmed |
Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_full |
Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_fullStr |
Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_full_unstemmed |
Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_short |
Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_sort |
exploring the precision of femtosecond laser-assisted descemetorhexis in descemet membrane endothelial keratoplasty |
| topic |
Ophthalmology |
| url |
http://dx.doi.org/10.1136/bmjophth-2018-000148 |
| publishDate |
2018 |
| physical |
e000148 |
| description |
<jats:sec><jats:title>Objective</jats:title><jats:p>Descemet membrane endothelial keratoplasty (DMEK) remains a challenging technique. We compare the precision of femtosecond laser-assisted DMEK to manual DMEK.</jats:p></jats:sec><jats:sec><jats:title>Methods and Analysis</jats:title><jats:p>A manual descemetorhexis (DR) of 8 mm diameter was compared with a femtosecond laser-assisted DR of the same diameter (femto-DR) in 22 pseudophakic patients requiring DMEK. We used OCT images with a centred xy-diagram to measure the postoperative precision of the DR and the amount of endothelial denuded area. Endothelial cell loss (ECL) and best corrected visual acuity were measured 3 months after surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the manual group, the median error of the DR was 7% (range 3%–16%) in the x-diameter and 8% (range 2%–17%) in the y-diameter. In the femto group, the median error in the respective x and y-diameters was 1% (range 0.4%–3%) and 1% (range 0.006%–2.5%), smaller than in the manual group (p=0.001). Endothelial denuded areas were larger in the manual group (11.6 mm<jats:sup>2</jats:sup>, range 7.6–18 mm<jats:sup>2</jats:sup>) than in the femto group (2.5 mm<jats:sup>2</jats:sup>, range 1.2–5.9 mm<jats:sup>2</jats:sup>) (p<0.001). The ECL was 21% (range 5%–78%) in the manual DR and 17% (range 6%–38%) in the femto-DR group (p=0.351). The median visual acuity increased from 0.4 logMAR (range 0.6–0.4 logMAR) in both groups to 0.1 logMAR (range 0.4–0 logMAR) in the manual group and to 0.1 logMAR (range 0.3–0 logMAR) in the femto group (p=0.461). Three rebubblings were required in the manual group, whereas the femto group required only one.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The higher precision of the femto-DR bears the potential to improve DMEK surgery.</jats:p></jats:sec> |
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| author | Pilger, Daniel, von Sonnleithner, Christoph, Bertelmann, Eckart, Maier, Anna-Karina B, Joussen, Antonia M, Torun, Necip |
| author_facet | Pilger, Daniel, von Sonnleithner, Christoph, Bertelmann, Eckart, Maier, Anna-Karina B, Joussen, Antonia M, Torun, Necip, Pilger, Daniel, von Sonnleithner, Christoph, Bertelmann, Eckart, Maier, Anna-Karina B, Joussen, Antonia M, Torun, Necip |
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| description | <jats:sec><jats:title>Objective</jats:title><jats:p>Descemet membrane endothelial keratoplasty (DMEK) remains a challenging technique. We compare the precision of femtosecond laser-assisted DMEK to manual DMEK.</jats:p></jats:sec><jats:sec><jats:title>Methods and Analysis</jats:title><jats:p>A manual descemetorhexis (DR) of 8 mm diameter was compared with a femtosecond laser-assisted DR of the same diameter (femto-DR) in 22 pseudophakic patients requiring DMEK. We used OCT images with a centred xy-diagram to measure the postoperative precision of the DR and the amount of endothelial denuded area. Endothelial cell loss (ECL) and best corrected visual acuity were measured 3 months after surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the manual group, the median error of the DR was 7% (range 3%–16%) in the x-diameter and 8% (range 2%–17%) in the y-diameter. In the femto group, the median error in the respective x and y-diameters was 1% (range 0.4%–3%) and 1% (range 0.006%–2.5%), smaller than in the manual group (p=0.001). Endothelial denuded areas were larger in the manual group (11.6 mm<jats:sup>2</jats:sup>, range 7.6–18 mm<jats:sup>2</jats:sup>) than in the femto group (2.5 mm<jats:sup>2</jats:sup>, range 1.2–5.9 mm<jats:sup>2</jats:sup>) (p<0.001). The ECL was 21% (range 5%–78%) in the manual DR and 17% (range 6%–38%) in the femto-DR group (p=0.351). The median visual acuity increased from 0.4 logMAR (range 0.6–0.4 logMAR) in both groups to 0.1 logMAR (range 0.4–0 logMAR) in the manual group and to 0.1 logMAR (range 0.3–0 logMAR) in the femto group (p=0.461). Three rebubblings were required in the manual group, whereas the femto group required only one.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The higher precision of the femto-DR bears the potential to improve DMEK surgery.</jats:p></jats:sec> |
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| spelling | Pilger, Daniel von Sonnleithner, Christoph Bertelmann, Eckart Maier, Anna-Karina B Joussen, Antonia M Torun, Necip 2397-3269 BMJ Ophthalmology http://dx.doi.org/10.1136/bmjophth-2018-000148 <jats:sec><jats:title>Objective</jats:title><jats:p>Descemet membrane endothelial keratoplasty (DMEK) remains a challenging technique. We compare the precision of femtosecond laser-assisted DMEK to manual DMEK.</jats:p></jats:sec><jats:sec><jats:title>Methods and Analysis</jats:title><jats:p>A manual descemetorhexis (DR) of 8 mm diameter was compared with a femtosecond laser-assisted DR of the same diameter (femto-DR) in 22 pseudophakic patients requiring DMEK. We used OCT images with a centred xy-diagram to measure the postoperative precision of the DR and the amount of endothelial denuded area. Endothelial cell loss (ECL) and best corrected visual acuity were measured 3 months after surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the manual group, the median error of the DR was 7% (range 3%–16%) in the x-diameter and 8% (range 2%–17%) in the y-diameter. In the femto group, the median error in the respective x and y-diameters was 1% (range 0.4%–3%) and 1% (range 0.006%–2.5%), smaller than in the manual group (p=0.001). Endothelial denuded areas were larger in the manual group (11.6 mm<jats:sup>2</jats:sup>, range 7.6–18 mm<jats:sup>2</jats:sup>) than in the femto group (2.5 mm<jats:sup>2</jats:sup>, range 1.2–5.9 mm<jats:sup>2</jats:sup>) (p<0.001). The ECL was 21% (range 5%–78%) in the manual DR and 17% (range 6%–38%) in the femto-DR group (p=0.351). The median visual acuity increased from 0.4 logMAR (range 0.6–0.4 logMAR) in both groups to 0.1 logMAR (range 0.4–0 logMAR) in the manual group and to 0.1 logMAR (range 0.3–0 logMAR) in the femto group (p=0.461). Three rebubblings were required in the manual group, whereas the femto group required only one.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The higher precision of the femto-DR bears the potential to improve DMEK surgery.</jats:p></jats:sec> Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty BMJ Open Ophthalmology |
| spellingShingle | Pilger, Daniel, von Sonnleithner, Christoph, Bertelmann, Eckart, Maier, Anna-Karina B, Joussen, Antonia M, Torun, Necip, BMJ Open Ophthalmology, Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty, Ophthalmology |
| title | Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_full | Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_fullStr | Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_full_unstemmed | Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_short | Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| title_sort | exploring the precision of femtosecond laser-assisted descemetorhexis in descemet membrane endothelial keratoplasty |
| title_unstemmed | Exploring the precision of femtosecond laser-assisted descemetorhexis in Descemet membrane endothelial keratoplasty |
| topic | Ophthalmology |
| url | http://dx.doi.org/10.1136/bmjophth-2018-000148 |