Ziemer Ophtalmology

State-of-the-Art Keratoconus Diagnosis and Treatment

Webinar at the CXL Experts' Meeting 2020

 


Moderation:

Prof. Shady Awwad, Lebanon

Faculty: 
Prof. Shady Awwad, Lebanon | Time: 00:54 & 47:48
The Galilei Corneal Thickness Progression: a fixation independent method for early Keratoconus detection

Femto Arcuate Keratotomy: Debulking astigmatism in Corneal grafts for Keratoconus

Prof. Luis Izquierdo, Peru | Time: 11:20
Improving visual outcomes for Keratoconus using intracorneal ring segments assisted by femtosecond laser

Prof. Theo Seiler, Switzerland | Time: 21:09
DALK demystified with Femto technology

Prof. Gerald Schmidinger, Austria | Time: 37:19
Femto assisted DALK surgery – study results

Questions and Answers

The following questions have been arised during the webinar. Prof. Seiler and Prof. Awwad answered them here:



Prof. Theo Seiler, Switzerland –
Time: 21:09
DALK demystified with Femto technology

Question 1: 
What is the advantage of mushroom design for DALK?






Question 2: 

What is the average suture removal time after Femto DALK?

Answer 1:
Regarding the diameters of grafts we have 2 concurrent trends:  (1) larger diameter makes less astigmatism, but higher rejection rates (2) smaller diameters produce less rejections but higher astigmatism. In case of a conversion from DALK to PKP we still have a donor graft which combines low astigmatism and low rejection potential.

Answer 2:
First remove 6-9 months, second at 12 to 15 months (depending on age).

Prof. Shady Awwad, Lebanon - Time: 47:48
Femto Arcuate Keratotomy: Debulking astigmatism in Corneal grafts for Keratoconus

Question 1:
Did u ever experience graft host junction dehiscence during Femto AK ?



Question 2:
On what do you depend on measuring the astigmatism? Is it the subjective astigmatism or topographic astigmatism?

 

Answer 1:
No. I have not. The FEMTO LDV Z8 uses liquid interface docking in Femto AK, and hence the stress on the graft host interface is much lower than conventional docking. Care however should be taken to ensure the graft host interface is not dehisced to start with.

Answer 2:
The AK and Femto AK nomograms are all based on corneal astigmatism and not refractive astigmatism.