Endothelial Approach Ultrathin Corneal Grafts Prepared by Femtosecond Laser for Descemet Stripping Endothelial Keratoplasty

Liu, Yu-Chi; Teo, Ericia Pei Wen; Adnan, Khadijah; Yam, Gary Hin Fai; Peh, Gary S L; Tan, Donald

doi:10.1167/iovs.14-15080

Cited by 29 publications

(17 citation statements)

References 32 publications

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“…These donor corneas were generally either older in term of donor age (>40 years), or days of preservation (>14 days), as well as being of low endothelial cell count (<2,000 cells). Laser dissection of a layer of ultrathin human corneal stroma lenticules with DM-endothelium complex intact, at a diameter of at least 8.0 mm, was performed using a Ziemer laser (LDV) femtosecond laser system as described 65 . Corneoscleral buttons were dissected from the endothelial surface with the lamellar dissection depth set at 100 µm.…”

Section: Methodsmentioning

confidence: 99%

Regulatory Compliant Tissue-Engineered Human Corneal Endothelial Grafts Restore Corneal Function of Rabbits with Bullous Keratopathy

Peh

Ang

Lwin

et al. 2017

Sci Rep

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Corneal transplantation is the only treatment available to restore vision for individuals with blindness due to corneal endothelial dysfunction. However, severe shortage of available donor corneas remains a global challenge. Functional regulatory compliant tissue-engineered corneal endothelial graft substitute can alleviate this reliance on cadaveric corneal graft material. Here, isolated primary human corneal endothelial cells (CEnCs) propagated using a dual media approach refined towards regulatory compliance showed expression of markers indicative of the human corneal endothelium, and can be tissue-engineered onto thin corneal stromal carriers. Both cellular function and clinical adaptability was demonstrated in a pre-clinical rabbit model of bullous keratopathy using a tissue-engineered endothelial keratoplasty (TE-EK) approach, adapted from routine endothelial keratoplasty procedure for corneal transplantation in human patients. Cornea thickness of rabbits receiving TE-EK graft gradually reduced over the first two weeks, and completely recovered to a thickness of approximately 400 µm by the third week of transplantation, whereas corneas of control rabbits remained significantly thicker over 1,000 µm (p < 0.05) throughout the course of the study. This study showed convincing evidence of the adaptability of the propagated CEnCs and their functionality via a TE-EK approach, which holds great promises in translating the use of cultured CEnCs into the clinic.

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Section: Methodsmentioning

confidence: 99%

Regulatory Compliant Tissue-Engineered Human Corneal Endothelial Grafts Restore Corneal Function of Rabbits with Bullous Keratopathy

Peh

Ang

Lwin

et al. 2017

Sci Rep

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“…Femtosecond lasers have been applied to the field of refractive surgery 16 , cataract surgery 17 and corneal transplantation 18,19 , providing reproducible, accurate and reliable capsulotomy 20 , corneal flaps, stromal lenticules 21 , or corneal grafts 18,19 . In order to attempt to transfer these favorable characteristics of femtosecond lasers to pterygium surgery, recently, we described a new technique, in which a low-energy, high-frequency femtosecond laser (Z8 LDV, Ziemer Ophthalmic Systems AG, Port, Switzerland) was used to prepare CAGs in pterygium surgery 22,23 .…”

mentioning

confidence: 99%

Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

Liu

Tan

et al. 2020

Sci Rep

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Femtosecond laser-assisted conjunctival autografts (CAG) preparation was recently proposed. This study reports the outcomes of the first clinical trial on the use of laser to prepare CAG in pterygium surgery, and to compare the outcomes with those of manual technique. Forty eyes undergoing primary pterygium excision with laser-assisted CAG transplantation were prospectively included (L group). Two historical matched cohorts whose cAGs were prepared manually were compared (n = 78 eyes by the same experienced surgeon, M group; n = 78 eyes by trainees; TM group). We found the laser-created CAGs had only 11 μm deviation from the targeted thickness. The best-corrected visual acuity improved, and the astigmatism significantly decreased after surgery, with comparable efficacy across 3 groups. The 1-year recurrence rate was 2.5%, 3.8% and 7.7% in the L, M and TM groups, respectively (P = 0.12). There was no significant difference between the L and M groups in the complication rate (5.0% and 1.3%, respectively), surgical time (19.4 ± 5.1 and 19.1 ± 6.2 minutes, respectively), and postoperative discomfort scores (0.1 ± 0.3 and 0.2 ± 0.3, respectively), but these outcomes were significantly less favorable in the TM group. The results of this first comparative clinical trial suggest that femtosecond laser-assisted CAG preparation can be considered as an alternative technique for CAGs preparation.

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“…Endothelial cell counts are in keeping with previous studies of DSAEK and are obviously affected by insertion technique as well as applanating and laser application. It is possible that cell counts could have been improved with use of Viscoat (Alcon, Fort Worth, TX, USA) as an interface fluid …”

Section: Patient Demographics and Results At 6‐month Visit Post‐femtomentioning

confidence: 99%

Ultrathin descemet stripping automated endothelial keratoplasty using a femtosecond laser to cut grafts from the endothelial side

McKee¹,

Jhanji

2015

Clinical Exper Ophthalmology

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Endothelial Approach Ultrathin Corneal Grafts Prepared by Femtosecond Laser for Descemet Stripping Endothelial Keratoplasty

Abstract: The corneal endothelial grafts prepared by LDV femtosecond laser with endothelial approach produced consistently ultrathin grafts in uniform shape with high accuracy and good endothelial and stromal interface quality.

Cited by 29 publications

References 32 publications

Regulatory Compliant Tissue-Engineered Human Corneal Endothelial Grafts Restore Corneal Function of Rabbits with Bullous Keratopathy

Regulatory Compliant Tissue-Engineered Human Corneal Endothelial Grafts Restore Corneal Function of Rabbits with Bullous Keratopathy

Femtosecond Laser-assisted Preparation of Conjunctival Autograft for Pterygium Surgery

Ultrathin descemet stripping automated endothelial keratoplasty using a femtosecond laser to cut grafts from the endothelial side

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