BLOOD-AQUEOUS BARRIER AFTER MECHANICAL OR NONMECHANICAL EXCIMER-LASERTREPHINATION IN PENETRATING KERATOPLASTY

PURPOSE: To analyze whether nonmechanical trephination with an excimer laser influences postoperative blood aqueous barrier breakdown after penetrating keratoplasty, METHODS: Patients undergoing penetrating ker atoplasty for keratoconus or Fuchs dystrophy were prospectively random ly assigned to trephination by either excimer laser or conventional me chanical handheld motorized trephine, All surgery was performed by one surgeon, and preoperative, intraoperative, and postoperative treatmen t was identical in both groups. Aqueous Bare was quantitatively determ ined postoperatively in a masked fashion by laser Bare-cell meter, For statistical analysis, the nonparametric Wilcoxon Mann-Whitney test: w as used, RESULTS: A total of 52 eyes of 52 patients were examined (Fuc hs dystrophy, 10; keratoconus, 4-2), During the early postoperative pe riod (days 3 to 9), eyes that had undergone nonmechanical excimer lase r trephination (25/52) showed significantly (P <.005) lower flare valu es than did eyes that had undergone mechanical trephination (27/ 52). In both groups, Bare values returned to normal levels by 6 weeks posto peratively, CONCLUSION: Early postoperative blood-aqueous barrier brea kdown is less pronounced after penetrating keratoplasty with nonmechan ical excimer laser trephination.