Femtosecond laser-assisted large-diameter lamellar corneal-limbal keratoplasty in ocular chemical burns

Purpose: This study highlights the feasibility of femtosecond laser-assisted large-diameter lamellar corneal-limbal keratoplasty and its efficacy in the treatment of ocular surface failure caused by bilateral ocular chemical injury.

Observations: The series included 3 patients with ocular surface failure caused by bilateral ocular chemical burns. After dissection of the host cornea, a femtosecond laser-assisted large-diameter lamellar corneoscleral button, with varying thickness of 250-400 μm, was sutured to the recipient bed. Postoperatively, patients were maintained on topical corticosteroids drops and systemic immunosuppression. Patients were followed up for a minimum of 16 months. The preoperative best corrected visual acuity was counting fingers, hand motions, and hand motions respectively. Postoperatively, the preoperative best corrected visual acuity reached 20/50, 20/50 and 20/40 at the last follow-up, respectively. A stable ocular surface was achieved in all but one eye, due to the cessation of immunosuppressive drugs. Postoperative anterior segment optical coherence tomography revealed well apposed graft interface in all cases.

Conclusions and importance: Compared with conventional techniques, femtosecond laser is useful to create varying thickness corneoscleral graft to rehabilitate ocular surface and visual acuity in patients with bilateral ocular chemical burns.