Customized excimer laser lamellar transplantations: follow-up at one year

Objectives: To assess the refractive and visual acuity results of customized excimer laser lamellar transplantations as an alternative to penetrating keratoplasties for treatment of keratoconus. Methods: This retrospective review of 15 eyes of 15 patients with mild to moderate keratoconus underwent customized excimer laser lamellar transplantations utilizing a CLAT procedure. Results: The mean preoperative uncorrected visual acuity (UCVA) was 20/200 (0.11±0.11 SD) and the mean preoperative best spectacle corrected visual acuity (BSCVA) was 20/50 (0.48±0.23 SD), with a mean manifest refraction spherical equivalent (MRSE) refraction of )4.75 D (±5.27). The mean preoperative corneal thickness was 411.7 lm (±29.6 lm) (range from 382 to 484 lm); the mean preoperative keratometric astigmatism was 4.86 D (±2.52 D) range from (1.65 to 7.47 D) and the mean refractive corneal power of 51.94 D (±5.22 SD). At 12 months follow-up, the mean UCVA was 20/30 (0.65±0.19 SD) and mean BSCVA was 20/22 (0.85±0.23 SD) with a mean MRSE of -1.12 D (±0.26 SD). The mean corneal thickness was 620.6 lm (±45.73 SD) (range from 514 to 671); the mean keratometric astigmatism was 2.78 D (±0.75 SD) (range from 2.25 to 3.31 D) and mean refractive corneal power of 48.01 D (±2.38). Conclusions: Customized excimer laser lamellar transplantation restores normal corneal shape and thickness in keratoconus patients with a unique advantage of customizing both the recipient bed and the donor lamella. This procedure is safe and effective for treatment of mild to moderate keratoconus as an alternative to PK.