RESUMO
PURPOSE: To report the results of femtosecond laser-assisted 'mushroom-shaped wound-configurized keratoplasty' in 6 patients based on the results of experimental models in rabbits' and enucleated porcine eyes. METHODS: Mushroom-shaped donor corneal grafts were designed and transplanted in 3 rabbit eyes and 10 enucleated porcine eyes. The histologic findings were observed and wound burst pressure compared between penetrating keratoplasty (PKP) and mushroom-shaped keratoplasty. The 'mushroom-shaped wound-configurized keratoplasty' was subsequently performed in 6 eyes of 6 patients. RESULTS: In all eyes of the rabbits, histologic findings showed stable wound structure. In the porcine models, mushroom-shaped keratoplasty showed a better resistance to IOP than PKP after complete suture. Patients who underwent the surgery showed an improvement of over 2 lines in Snellen visual acuity after the operation. The mean follow-up period was approximately 11 months. Complete suture removal was performed within 6 months and accurate and stable wound structure was identified. CONCLUSIONS: Wound-configurized keratoplasty with femtosecond laser and mechanical dissection' has shown several advantages in the lamellar structure of the wound. Stable wound structure, less astigmatism, rapid suture removal and visual rehabilitation was achieved.