Femtosecond Laser DALK (FSDALK)
Watch Medical Director Sheraz Daya performing a Deep Anterior Lamellar Keratoplasty using the Femtosecond Laser.
WARNING: Contains Graphic Content.
Lasers are more precise. The same lasers used for laser eye surgery have been adapted for use in corneal transplants and Centre for Sight has been an innovator in this area. Having performed the first transplant of this type in the UK in 2004, further advances have resulted in better and more reliable outcomes. The Zag – Square or modified mushroom technique was developed at Centre for Sight and the video above illustrates the technique. The video won prizes at both the American Society of Cataract and Refractive Surgery 2013 and European Society of Cataract and Refractive Surgery 2013.
The Intralase femtosecond laser provides surgeons with the ability to make very precise incisions in the cornea and these can be combined in a multitude of ways to enhance penetrating keratoplasty or full thickness graft surgery.
Traditionally a circular blade or trephine is used to mechanically cut a circular incision in both donor and patient. The donor cornea is then stitched into the host. With the Intralase laser, we can create “tongue and groove” patterns to ensure a good fit without any slippage. This ensures good wound apposition and theoretically should reduce astigmatism. The laser additionally creates a wound healing reaction which also creates good adhesion allowing earlier stitch removal. Visual recovery is faster than a traditional method of trephination.
The video above illustrates the technique well.
Authored by Sheraz Daya MD FACP FACS FRCS(Ed) FRCOphth, Consultant Ophthalmic Surgeon & Medical Director, June 2019.
Next review due June 2020.