LIKE (Lenticular Intrastromal Keratoplasty) Procedure

Benjamin Buckner, MD, Majid Moshirfar MD, Steven H. Linn, OD, Trey W. Fanning, BS

This video documents the first Lenticular Intrastromal Keratoplasty, or LIKE procedure, performed in the United States. The procedure was performed by Dr. Majid Moshirfar at Hoopes Vision located in Draper, UT. The patient elected to undergo LIKE in an attempt to correct 6.0 D of hyperopia.
A disc of stromal tissue, called a lenticule, was provided by the Georgia Eye Bank. The lenticule had 7.0 D of power, a central pachymetry of 157 microns, and was 7.0 mm in diameter. The lenticule was placed under a flap created by the Wavelight FS200 femtosecond laser. The largest possible flap was created in order to reduce the size of the post-operative gutter. In this case, a flap with diameter of 9.6 mm and depth of 100 microns was created.
The cornea was marked at four cardinal positions prior to lifting the flap to assist in lenticule centration.
Post-operative OCT images show the lenticule centered and in good position. Pre- and post-operative data is shown below.

Pre-op:
UCVA: 20/30
MRx: +6.00 -1.00 x 040
BCVA: 20/20

1-day post-op:
UCVA: 20/200
MRx: -3.5 -1.25 x 093
BCVA: 20/63

2-day post-op:
UCVA: 20/200
MRx: -3.25 -1.25 x 065
BCVA: 20/30

1-week post-op:
UCVA: 20/50
MRx: -1.25 -1.00 x 088
BCVA: 20/30

Posted: 2/25/2019