Augenklinik Am Neumarkt, Private Eye Clinic, Schildergasse 107-109, 50667, Cologne, Germany.
MVZ Dres. Gerten & Kermani Leverkusen GmbH, Artemis Eye Center Leverkusen, Leverkusen, Germany.
Laserforum Köln E.V, Cologne, Germany.
Technische Hochschule Köln, University of Applied Sciences, Cologne, Germany.
目的
与传统手术相比，一种新的飞秒激光辅助深前板层角膜移植术（Clear Cornea Femto DALK 或 CCF DALK）可以在较少的技术挑战下进行。本文报告了评估该技术的初步案例系列。
方法
首先，通过透明角膜方法，后弹力膜 (DM) 与后部基质完全分离，方法是通过插入深部基质并位于 DM 正上方而不穿孔的特殊套管注入平衡盐溶液/粘弹性物质。注射会产生一个液体腔，它可以分离 DM，同时保留相当透明的角膜基质。之后，在光学相干断层扫描控制下，使用飞秒激光系统对基质进行完整的后/前环钻，从液室到上皮。
结果
这项技术在 10 只眼睛/10 名患者的初步系列中成功实施。所有患者的 DM 完全裸露，并在 6 个月后保持其自身的内皮细胞群，细胞损失最小 (< 15%)。术后界面反应极少，迄今未观察到免疫反应。
结论
透明角膜 Femto DALK 是以前 Femto DALK 程序的一种有前途的替代方案，对迄今为止所见的组织具有良好的接受度。
Purpose
A new femtosecond laser assisted deep anterior lamellar keratoplasty technique (Clear Cornea Femto DALK or CCF DALK) can be performed with less technical challenges compared to conventional procedures. This paper reports on a preliminary case series to evaluate the technique.
Method
First, through a clear cornea approach, Descemet’s membrane (DM) is completely separated from posterior stroma by injection of balanced salt solution/viscoelastic substance through a special cannula inserted into the deep stroma and positioned right above the DM without perforating. The injection creates a liquid chamber that detaches the DM while preserving a reasonably transparent corneal stroma. Afterwards, a complete posterior/anterior trephination of the stroma, from the liquid chamber to the epithelium, is done using a femtosecond laser system under optical coherence tomography control.
Results
This technique was successfully performed in a preliminary series of 10 eyes/10 patients. All patients had the DM completely bared and kept their own endothelial cell population with minimal cell loss (< 15%) after 6 months. Postoperative interface reaction was minimal, and no immune reactions were observed thus far.
Conclusion
Clear Cornea Femto DALK is a promising alternative to previous Femto DALK procedures with good acceptance of the tissue seen to date.
