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Novel Approach for the Treatment of Corneal Ectasia in a Graft

Dang, Tam Q. DO*; Molchan, Ryan P. MD*; Taylor, Kenneth R. BS; Reilly, Charles D. MD*; Panday, Vasudha A. MD*; Caldwell, Matthew C. MD*

doi: 10.1097/ICO.0000000000000052
Case Report

Purpose: The aim of this study was to report the use of novel masking agents during an anterior lamellar keratoplasty performed using a femtosecond laser in a patient with corneal ectasia that was consistent with recurrent keratoconus.

Methods: This is a case report.

Results: A 55-year-old man, with a 23-year status after penetrating keratoplasty for keratoconus, presented with a chief complaint of ocular discomfort in the right eye. On slit-lamp examination, the physician estimated 70% to 80% inferior thinning at the graft–host interface with inferior corneal neovascularization. Because of the high risk of developing corneal perforation and the patient's desire to minimize visual recovery time, anterior lamellar keratoplasty was chosen. To minimize the risk of perforation during femtosecond dissection of the anterior lamellar bed, gentian violet and cyanoacrylate glue were used in the area of thinning as masking agents.

Conclusions: This represents the first documented use of gentian violet and cyanoacrylate glue as double masking agents to defocus the femtosecond laser raster pass during keratoplasty.

*Joint Warfighter Refractive Surgery Center, Wilford Hall Ambulatory Surgical Center, Department of Ophthalmology, Lackland AFB (San Antonio), TX; and

Emory University School of Medicine, Atlanta, GA.

Reprints: Vasudha A. Panday, Joint Warfighter Refractive Surgery Center, 9402 Mariposa Pass, San Antonio, TX 78251 (e-mail: vasudha.panday@us.af.mil).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.corneajrnl.com).

Charles D. Reilly is a consultant to Alcon Labs and Abbott Medical Optics at present but was not at the time of the study. The other authors have no funding or conflicts of interest to disclose.

Received September 14, 2013

Accepted November 08, 2013

© 2014 by Lippincott Williams & Wilkins.