{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:37:47Z","timestamp":1792071467869,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2020,9,3]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To evaluate the feasibility and the initial outcomes of a novel standardized surgical technique of femtosecond laser- (FSL-) assisted big-bubble deep anterior lamellar keratoplasty (BBDALK) for eyes with keratoconus. <jats:italic>Methods<\/jats:italic>. This prospective interventional case series included 11 consecutive FSL-assisted BBDALK procedures performed for the eyes with keratoconus from September 2019 to December 2019. The FSL was used to create (i) an intrastromal channel incision (1.7\u2009mm in length, 4.6\u2009mm in width, 80% depth, and cut energy of 1.70\u2009<jats:italic>\u03bc<\/jats:italic>J) and (ii) a 9.0\u2009mm diameter circular lamellar side cut 65\u2009<jats:italic>\u03bc<\/jats:italic>m above the endothelium (cut energy of 0.90\u2009<jats:italic>\u03bc<\/jats:italic>J) intersecting the intrastromal incision. In the operating room, a blunt dissector was used to open the intrastromal channel incision, through which a blunt spatula was inserted, tangentially advanced towards the center of the cornea, and replaced with a blunt cannula for pneumatic dissection. The subsequent surgical steps did not differ from the conventional technique. Main outcome measures were the success rate of pneumatic dissection and the percentage of intraoperative complications. <jats:italic>Results<\/jats:italic>. Eleven eyes of 11 patients (6 males and 5 females; mean age: 34.54\u2009\u00b1\u200913.23 years) underwent FSL-assisted DALK. Using the FSL, both corneal incisions (lamellar side cut and intrastromal channel incision) were successfully created in all cases without the need for repeat docking or additional dissection. Pneumatic dissection with type 1 bubble formation succeeded in all 11 eyes (100%). DALK surgery was completed uneventfully in all cases. Descemet membrane perforation did not occur in any case, and no procedure was converted to penetrating keratoplasty. <jats:italic>Conclusion<\/jats:italic>. Using standardized FSL parameters for both incision design and cut energy in BBDALK surgery, pneumatic dissection can be achieved in a very high rate of cases with minimal risk of intraoperative complications.<\/jats:p>","DOI":"10.1155\/2020\/5496162","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T23:31:06Z","timestamp":1599175866000},"page":"1-5","source":"Crossref","is-referenced-by-count":14,"title":["Preliminary Results of a Novel Standardized Technique of Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty for Keratoconus"],"prefix":"10.1155","volume":"2020","author":[{"given":"Andrea","family":"Lucisano","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-0289","authenticated-orcid":true,"given":"Giuseppe","family":"Giannaccare","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, S. Orsola-Malpighi University Hospital, Via Palagi 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Bernabei","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, S. Orsola-Malpighi University Hospital, Via Palagi 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5654-3942","authenticated-orcid":true,"given":"Angeli Christy","family":"Yu","sequence":"additional","affiliation":[{"name":"University of Ferrara, Department of Morphology, Surgery and Experimental Medicine, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriano","family":"Carnevali","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Logozzo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Carnovale 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