New Therapeutic Modalities in Femtosecond Laser-assisted Corneal Surgery

Shousha, Mohamed Abou; Yoo, Sonia H.

doi:10.1097/iio.0b013e3181e247da

Cited by 7 publications

(3 citation statements)

References 64 publications

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“…The femtosecond laser is widely used to perform laser in situ keratomileusis (LASIK) 1 and penetrating keratoplasty (PKP). 2 However, it is not as commonly used for anterior or posterior lamellar keratoplasty because deep lamellar cuts produce irregular surfaces.…”

mentioning

confidence: 99%

Interface quality of different corneal lamellar–cut depths for femtosecond laser–assisted lamellar anterior keratoplasty

Zhang

Bald

Tang

et al. 2015

Journal of Cataract and Refractive Surgery

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PURPOSE To evaluate interface quality of different corneal lamellar–cut depths with the femtosecond laser and determine a feasible range of depth for femtosecond laser–assisted lamellar anterior keratoplasty. SETTING Casey Eye Institute, Portland, Oregon, USA. DESIGN Experimental study. METHODS Full lamellar cuts were made on 20 deepithelialized human cadaver corneas using the femtosecond laser. The cut depth was 17% to 21% (100 μm), 31%, 35%, 38% to 40%, and 45% to 48% of the central stromal thickness. Scanning electron microscopy images of cap and bed surfaces were subjectively graded for ridge and roughness using a scale of 1 to 5 (1 = best). The graft–host match was evaluated by photography and optical coherence tomography in a simulated procedure. RESULTS The ridge score was correlated with the cut depth (P = .0078, R = 0.58) and better correlated with the percentage cut depth (P = .00024, R = 0.73). The shallowest cuts had the least ridges (score 1.25). The 31% cut depth produced significantly less ridges (score 2.15) than deeper cuts. The roughness score ranged from 2.19 to 3.08 for various depths. A simulated procedure using a 100 μm host cut and a 177 μm (31%) graft had a smooth interface and flush anterior junction using an inverted side-cut design. CONCLUSIONS The femtosecond laser produced more ridges in deeper lamellar cuts. A depth setting of 31% stromal thickness might produce adequate surface quality for femtosecond laser–assisted lamellar anterior keratoplasty. The inverted side-cut design produced good edge apposition even when the graft was thicker than the host lamellar–cut depth.

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mentioning

confidence: 99%

Interface quality of different corneal lamellar–cut depths for femtosecond laser–assisted lamellar anterior keratoplasty

Zhang

Bald

Tang

et al. 2015

Journal of Cataract and Refractive Surgery

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“…The predictability of flap thickness and ability to create uniform (planar) flaps have minimized the risk of flap complications such as epithelial defects, button holes, irregular and partial flaps as well as resulting in less surgically induced refractive errors [3,6,10-12]. Moreover, the surgeon has control over angulation of the flap edge that may also impact flap healing, stability and prevent epithelial invasion [13]. Femtosecond laser-created flaps have shown stronger adhesion at the flap edge and interface compared with microkeratome flaps making them more resilient to trauma [14][15][16][17].…”

Section: Laser In-situ Keratomileusis Flap Creationmentioning

confidence: 99%

Applications of the femtosecond laser in corneal refractive surgery

Kim

Sutton

Rootman

2011

Current Opinion in Ophthalmology

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“…This surgical device allows cutting of corneal tissue in a number of reproducible, customised transplant designs, and allows the use of sagittal plane trephination profiles, such as zigzag, top-hat, Christmas tree and mushroom shapes to improve wound stability and, probably, postoperative astigmatism 1–5. The unique capability of the FS laser to photo-disrupt tissue with minimal collateral damage has made it a promising tool for increasing accuracy and predictability in corneal surgery 6. It has mainly been used in refractive surgery, for example, for flap preparation in Laser in Situ Keratomileusis (LASIK), for intrastromal corneal ring segments (ICRS) implantation in keratoconus patients7 or astigmatic keratotomy.…”

Section: Introductionmentioning

confidence: 99%