Jost B.Jonas

Department of Ophthalmology，Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg，Germany
100005

Purpose:To study the feasibility of the femtosecond laser technique for a patient，who underwent femtosecond laser keratoplasty after a previous keratoplasty had failed.

Method:A 48-year old patient had undergone conventional trephine guided penetrating keratoplasty as treatment of keratoconus in 1991，showing progressive intrastromal edema due to a progressive insufficiency of the corneal endothelium of the graft.Using a femtosecond laser，a penetrating re-keratoplasty was carried out.A top-hat cutting configuration was chosen.

Results:Despite the dense corneal opacities in the zone of the interface between the previous graft and the host cornea，the femtosecond laser was able to cut the corneal tissue unremarkably.The central corneal button pre-cut by the laser could be removed without further use of a knife or scissor.At 3 months after the intervention，visual acuity was 20/20.

Conclusions:The results suggest that the femtosecond laser is able to perform cuttings in the superficial and deep corneal layers including Descemet’s membrane through dense intracorneal opacities such as scars in the interface after a previous penetrating keratoplasty.