PMID- 24559515 OWN - NLM STAT- MEDLINE DCOM- 20150126 LR - 20140318 IS - 1773-0597 (Electronic) IS - 0181-5512 (Linking) VI - 37 IP - 3 DP - 2014 Mar TI - Femtosecond and excimer laser-assisted endothelial keratoplasty (FELEK): a new technique of endothelial transplantation. PG - 211-9 LID - S0181-5512(14)00014-X [pii] LID - 10.1016/j.jfo.2013.07.009 [doi] AB - PURPOSE: To describe a new technique of endothelial keratoplasty (EK) that improves the quality of lamellar dissection of donor cornea. METHODS: We compared four techniques of donor cornea preparation for lamellar dissection on 8 donor corneas: mechanical dissection with a microkeratome, a single femtosecond laser lamellar cut, a double femtosecond laser lamellar cut and combined femtosecond laser lamellar dissection with excimer laser surface photoablation. The quality of the donor cornea interface was assessed and compared using scanning electron microscopy (SEM), and the most satisfactory technique was employed for EK on three patients. The postoperative anatomic results were analyzed with anterior segment spectral-domain optical coherence tomography (SD-OCT) and in vivo confocal microscopy (IVCM). RESULTS: The smoothest stromal interface was observed on SEM with the combined use of femtosecond laser dissection and excimer photoablation. The surgical procedures performed with donor cornea prepared by a combination of femtosecond and excimer lasers resulted in clear corneas after 1 month. SD-OCT showed good attachment of the endothelial graft and a hyperreflective interface. On IVCM, subepithelial haze, honeycomb-like activated keratocytes and needle-shaped particles were visible in the recipient corneal stroma as well as numerous hyperreflective particles on the donor-recipient interface. CONCLUSION: A new technique, femtosecond and excimer laser-assisted endothelial keratoplasty (FELEK), which refines the current limitations observed in Descemet-stripping automated endothelial keratoplasty (DSAEK), is described. Femtosecond laser dissection provides a thin and reproducible endothelial graft cut with a high level of safety and accuracy, while excimer photoablation yields a smooth, high-quality interface. CI - Copyright (c) 2014 Elsevier Masson SAS. All rights reserved. FAU - Trinh, L AU - Trinh L AD - Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Clinical Investigation Center (CIC) 503, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France. Electronic address: trinhdinhliem@gmail.com. FAU - Saubamea, B AU - Saubamea B AD - Inserm U705, UMR CNRS 8206, faculte des sciences pharmaceutiques et biologiques, 4, avenue de l'Observatoire, 75270 Paris cedex 06, France; Plateau technique d'imagerie cellulaire et moleculaire, IFR71-IMTCE, faculte des sciences pharmaceutiques et biologiques, universite Paris Descartes, 4, avenue de l'Observatoire, 75270 Paris cedex 06, France. FAU - Auclin, F AU - Auclin F AD - Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Clinical Investigation Center (CIC) 503, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France. FAU - Denoyer, A AU - Denoyer A AD - Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Clinical Investigation Center (CIC) 503, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Vision Institute, Inserm UMR S 968, UMR 7210, universite Pierre-et-Marie-Curie - Paris 6, 17, rue Moreau, 75012 Paris, France. FAU - Lai-Kuen, R AU - Lai-Kuen R AD - Plateau technique d'imagerie cellulaire et moleculaire, IFR71-IMTCE, faculte des sciences pharmaceutiques et biologiques, universite Paris Descartes, 4, avenue de l'Observatoire, 75270 Paris cedex 06, France. FAU - El Hamdaoui, M AU - El Hamdaoui M AD - Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Clinical Investigation Center (CIC) 503, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France. FAU - Labbe, A AU - Labbe A AD - Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Clinical Investigation Center (CIC) 503, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Vision Institute, Inserm UMR S 968, UMR 7210, universite Pierre-et-Marie-Curie - Paris 6, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise-Pare Hospital, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France; AP-HP, University of Versailles - Saint-Quentin-en-Yvelines, 55, avenue de Paris, 78000 Versailles, France. FAU - Despiau, M-C AU - Despiau MC AD - Department of Pharmacy, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France. FAU - Brignole-Baudouin, F AU - Brignole-Baudouin F AD - Vision Institute, Inserm UMR S 968, UMR 7210, universite Pierre-et-Marie-Curie - Paris 6, 17, rue Moreau, 75012 Paris, France. FAU - Baudouin, C AU - Baudouin C AD - Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Clinical Investigation Center (CIC) 503, Quinze-Vingts National Ophthalmology Hospital, 28, rue de Charenton, 75012 Paris, France; Vision Institute, Inserm UMR S 968, UMR 7210, universite Pierre-et-Marie-Curie - Paris 6, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise-Pare Hospital, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20140218 PL - France TA - J Fr Ophtalmol JT - Journal francais d'ophtalmologie JID - 7804128 SB - IM MH - Aged MH - Aged, 80 and over MH - Corneal Transplantation/*methods MH - Endothelium, Corneal/*transplantation/ultrastructure MH - Female MH - Humans MH - In Vitro Techniques MH - *Laser Therapy MH - *Lasers, Excimer MH - Microscopy, Electron, Scanning MH - Middle Aged MH - Time Factors OTO - NOTNLM OT - Cornea OT - Corneal graft OT - Cornee OT - Endothelial keratoplasty OT - Excimer laser OT - Femtosecond laser OT - Greffe de cornee OT - Keratoplastie endotheliale OT - Laser excimer OT - Laser femtoseconde EDAT- 2014/02/25 06:00 MHDA- 2015/01/27 06:00 CRDT- 2014/02/25 06:00 PHST- 2013/05/08 00:00 [received] PHST- 2013/07/04 00:00 [revised] PHST- 2013/07/05 00:00 [accepted] PHST- 2014/02/25 06:00 [entrez] PHST- 2014/02/25 06:00 [pubmed] PHST- 2015/01/27 06:00 [medline] AID - S0181-5512(14)00014-X [pii] AID - 10.1016/j.jfo.2013.07.009 [doi] PST - ppublish SO - J Fr Ophtalmol. 2014 Mar;37(3):211-9. doi: 10.1016/j.jfo.2013.07.009. Epub 2014 Feb 18.