Laser-assisted corneal welding in cataract surgery: Retrospective study

Abstract

Astigmatism was slightly affected by the use of laser welding for corneal wound closure after phacoemulsification and ECCE. The laser-assisted corneal sealing procedure was rapid and safe and could serve as an alternative to corneal suturing, with significant potential applications for the closure of longer incisions, such as those used in penetrating keratoplasty.

Laser tissue welding in ophthalmic surgery

“…In short, we found that optimized laser welding of a corneal wound could be achieved at quite low laser power densities (12-16 W/cm 2 ) and that the repair process of laser-welded corneal wounds started earlier than that of traditionally sutured wounds: objective and histological observations at two weeks after surgery showed a good morphology of laser-treated corneas, with almost restored cuts, generally characterized by lesser edematous appearance as compared to the sutured ones. The ICG solution was completely reabsorbed after three to seven postoperative days [4,5]. After 3 months the restored wound area appeared to have regained the transparency and the shape of the healthy cornea; at the microscopic level, the laser welded stroma collagen fibrils have a very linear shape and are organized in layers of regular thickness and orientation.…”

“…The main clinical applications of CWLW are in cataract surgery [5] and in penetrating keratoplasty (i.e. full thickness transplant of the cornea).…”

“…Laser tissue welding has proved to have several advantages as compared with conventional suturing methods, such as reduced operation times, watertight closures, decreased foreign-body reaction and therefore reduced inflammatory response, faster healing times, increased ability to induce regeneration of the original tissue architecture and an improved cosmetic appearance [4,5]. Despite the extensive experimental tests on different types of tissues performed in the last two decades, this approach has been clinically applied only in a few surgical applications, including in ophthalmology.…”

Tissue adhesives in ocular surgery

“…Cataract surgery was performed on 20 patients with a preoperative visual acuity worse than 20 out of 200 [188]. Ten patients had phacoemulsification surgery and ten had extracapsular cataract extraction (ECCE).…”

An “All-laser” Endothelial Transplant

“…The temperature enhancement induces reversible thermal denaturation in the stromal collagen, with an immediate closuring of the wound walls upon cooling. This laser welding effect was firstly demonstrated in cataract surgery 7,8 and penetrating keratoplasty 9,10 . An optimized approach that we are presenting in this paper has been studied for application in endothelial keratoplasty.…”