Purpose: To evaluate femtosecond laser-assisted corneal full-thickness trephination with orientation teeth and notches for penetrating keratoplasty (PKP).
Design: Interventional case series.
Methods: Four eyes of four patients aged 34 to 55 years underwent PKP using a femtosecond laser system enabling corneal trephination with orientation teeth and notches. Patients were affected by advanced keratoconus (n = 2) or postinfectious corneal scar (n = 2). Scanning electron microscopy (SEM) was performed to evaluate the cut quality of donor and recipient cornea.
Results: All procedures were completed without any complications. In all cases, the donor and the recipient cornea were cut with the same size of 8.0-mm diameter. A complete perforating cut was achieved in all eyes, and a correct intraoperative matching of teeth and notches was obtained. SEM of donor and recipient specimens showed a full-thickness cut with smooth and regular shape of orientation teeth and notches.
Conclusions: Orientation teeth and notches shaped PKP using the femtosecond laser technology is feasible and may offer further promising approaches toward customized trephination techniques.