Femtosecond laser-assisted corneal surgery

Purpose of review A look at the recent advances in corneal transplantation surgery using the femtosecond laser technology. Recent findings The femtosecond laser uses near-infrared light to create photodisruption, a process that allows corneal tissue to be cut at precise depths and in various patterns. Penetrating keratoplasty as well as disease targeted lamellar corneal surgery have been performed using this technology in order to improve surgical outcomes and wound healing. It is now possible to create customized trephination patterns, including 'zig-zag' and 'tophat', which demonstrate more rapid visual recovery and decreased amounts of astigmatism as compared with conventional blade trephination penetrating keratoplasty. The benefits of these cuts have been extended into the deep anterior lamellar keratoplasty surgery in order to maintain the benefits of the customized cut, whereas preserving the endothelial layer in ectatic and stromal diseases of the cornea. Summary Femtosecond laser-assisted corneal surgery is improving traditional outcomes in transplantation. Continued studies using this ultrafast laser may continue to yield new and exciting possibilities in the treatment of corneal disease.