ArticleBMC ophthalmology2026
Success of femtosecond laser-assisted deep anterior lamellar keratoplasty (Femto-DALK): a clinical case series of 42 eyes using an intraoperative optical coherence tomography (iOCT)-guided laser-generated pre-descemet tunnel.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the success of Femto-DALK with an iOCT-guided generated intrastromal pre-Descemet tunnel.
methodsThis monocentric, retrospective study evaluated all patients treated with Femto-DALK between January 2020 and December 2023 at the Department of Ophthalmology at the University of Düsseldorf (Germany). The iOCT-guided tunnel was generated 30 microns anterior of Descemet's membrane. BB generation, surgery time and conversion to penetrating keratoplasty (PK) were analyzed.
resultsA total of 42 eyes of 41 patients were identified. BB creation was successful in 78.6% of cases. Intraoperative conversion to PK was necessary in 28.6% of the eyes and microperforation of Descemet's membrane (DM) occurred in 16.7% of completed DALKs. Mean operation time was 118.6 ± 40.68 min. Among successful Femto-DALKs (n = 30), double anterior chamber was observed in 26.7%, and re-bubbling was needed in 23.3%. Re-keratoplasty was performed in one eye (3.3%).
conclusionFemto-DALK with an iOCT-guided pre-Descemet tunnel generation is a feasible technique that achieves BB success rates comparable to the upper range reported for manual dissection, without a clear demonstrated improvement over manual technique.
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