An “All-laser” Endothelial Transplant

Abstract

The "all laser" assisted endothelial keratoplasty is a procedure that is performed with a femtosecond laser used to cut the donor tissue at an intended depth, and a near infrared diode laser to weld the corneal tissue. The proposed technique enables to reach the three main goals in endothelial keratoplasty: a precise control in the thickness of the donor tissue; its easy insertion in the recipient bed and a reduced risk of donor lenticule dislocation. The donor cornea thickness is measured in the surgery room with optical coherence tomography (OCT), in order to correctly design the donor tissue dimensions. A femtosecond laser is used to cut the donor cornea. The recipient eye is prepared by manual stripping of the descemetic membrane. The donor endothelium is inserted into a Busin-injector, the peripheral inner side is stained with a proper chromophore (a water solution of Indocyanine Green) and then it is pulled in the anterior chamber. The transplanted tissue is placed in the final and correct location and then diode laser welding is induced from outside the eyeball. The procedure has been performed on more than 15 patients evidencing an improvement in surgery performances, with a good recovery of visual acuity and a reduced donor lenticule dislocation event. Video LinkThe video component of this article can be found at

Three‐dimensional mapping of the orientation of collagen corneal lamellae in healthy and keratoconic human corneas using SHG microscopy

“…Keratoconic corneas were trephined with a femtosecond laser and soaked into a tissue preservation solution (Carry C, AL.CHI.MI.A. Srl, Padova, Italy) immediately after trephination . Imaging of these samples was performed within 24 hours from excision.…”

Optically activated and interrogated plasmonic hydrogels for applications in wound healing

“…Moreover, suturing is a delicate practice that may be unsuitable in certain anatomical microstructures and surgical procedures, where the lack of alternatives really amounts to a substantial problem. Relevant examples include, for instance, several cases in Ophthalmology [37], such as transplantations of corneal endothelium [38,39] or the closure of the eye lens capsule [40] after Phaco-Ersatz procedure, and in Neurosurgery, such as microanastomoses of blood vessels [41][42][43] and nerves [44] or sealing of dura mater. Another issue is the formation of scars.…”