Zeitschrift für klinische und experimentelle Ophthalmologie
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Angled Mushroom Pattern Femtosecond Laser Lamellar Keratoplasty for Krumeich Ring Insertion: A Laboratory Study

Timothy Hsia, Maolong Tang, Billy Pan, Jorg H. Krumeich, Yan Li and David Huang

Background and objective: The aim of this laboratory study was to investigate an alternative corneal trephination technique, femtosecond laser-enabled keratoplasty (FLEK), for inserting and stabilizing the depth of a metallic alloy intrastromal corneal ring (ISCR) for penetrating keratoplasty (PKP).
Patients and methods: The FLEK procedures were performed on eye bank corneas mounted on an artificial anterior chamber. An angled mushroom pattern cut formed an elbow to support 7.5- and 8.0-mm ISCRs at 300 μm depth. Optical coherence tomography (OCT) was used to visualize the position of the inserted ISCR.
Results: OCT images showed that the diameters of the femtosecond laser cut patterns matched the size of the respective ISCRs. Both rings rested stably on the corneal rims even prior to suturing. After suturing, the depths for the 7.5-mm and 8.0-mm ISCRs were measured by OCT to be 301.0 μm and 299.5 μm, respectively.
Conclusion: The angled mushroom pattern cut by femtosecond laser may improve the predictability and stability of the ISCR position within the wound in PKP performed by FLEK.