Comparison Of Femtosecond Laser-assisted Keratoplasty Versus Conventional Keratoplasty-a Meta-analysis

TOPIC: To compare the clinical outcomes of femtosecondlaser-assisted keratoplasty (FLAK) and conventional keratoplasty (CK) forcorneal diseases.METHODS: A meta-analysis on published studies was performed tocompare the effectiveness and safety of FLAK and CK. We searchedPubmed, Embase, Cochrane Central and OVID through Jan2014. Allclinical data included were extracted and evaluated by two reviewersindependently. Data were analyzed using Review Manager software5.2.6by The Cochrane Collaboration.RESULTS: Seven studies were identified and analyzed for comparingFLAK (263eyes) with CK (250eyes) for corneal diseases. There weresignificant differences in short-term (MD=-1.59,95%CI [-2.86,-0.31],P=0.01)and long-term postoperative topographic astigmatism (MD=-1.17,95%CI [-1.97,-0.38], P=0.004) between the FLAK group and CK group.No difference was identified in short-term logarithm of the minimum angleof resolution (logMAR) best spectacle-corrected visual acuity (BSCVA)(MD=0.01,95%CI [-46,0.48], P=0.96), long-term BSCVA(MD=0.10,95%CI [-0.06,0.26], P=0.23), graft failure (RR=1.74,95%CI [0.74,4.07],P=0.2) and graft rejection (RR=0.57,95%CI [0.13,2.49], P=0.46).CONCLUSION: Both FLAK and CK are safe for treating cornealdiseases with low incidence of graft failure and rejection. They are equallyefficacious in improving short-and long-term postoperative BSCVA. However, compared to CK, FLAK is more effective in improving short-and long-term postoperative topographic astigmatism.