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Proceedings Paper

Combining femtosecond laser ablation and diode laser welding in lamellar and endothelial corneal transplants
Author(s): Roberto Pini; Francesca Rossi; Paolo Matteini; Fulvio Ratto; Luca Menabuoni; Ivo Lenzetti; Sonia H. Yoo; Jean-Marie Parel
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Paper Abstract

Based on our previous clinical experiences in minimally invasive diode laser-induced welding of corneal tissue in penetrating keratoplasty (PK), i.e. full-thickness transplant of the cornea, we combined this technique with the use of a femtosecond laser for applications in lamellar (LK) and endothelial (EK) keratoplasty. In LK, the femtosecond laser was used to prepare donor button and recipient corneal bed; the wound edges were stained with a water solution of Indocyanine Green (ICG) and then irradiated with a diode laser emitting in CW mode to induce stromal welding. Intraoperatory observations and follow-up results up to 6 months indicated the formation of a smooth stromal interface, total absence of edema as well as inflammation, and reduction of post-operative astigmatism, as compared with conventional suturing procedures. In EK the femtosecond laser was used for the preparation of a 100 &mgr;m thick, 8.5mm diameter donor corneal endothelium flap. The flap stromal side was stained with ICG. After stripping the recipient Descemet's membrane and endothelium, the donor flap was positioned in the anterior chamber on the inner face of the cornea by an air bubble and secured to the recipient cornea by diode laser pulses delivered by means of a fiberoptic contact probe introduced in the anterior chamber, which produced welding spots of 200 &mgr;m diameter. Femtosecond laser sculpturing of the donor cornea provided lamellar and endothelial flaps of preset and constant thickness. Diode laserinduced welding showed a unique potential to permanently secure the donor flap in place, avoiding postoperative displacement and inflammation reaction.

Paper Details

Date Published: 25 February 2008
PDF: 7 pages
Proc. SPIE 6844, Ophthalmic Technologies XVIII, 684411 (25 February 2008); doi: 10.1117/12.762945
Show Author Affiliations
Roberto Pini, Istituto di Fisica Applicata (Italy)
Francesca Rossi, Istituto di Fisica Applicata (Italy)
Paolo Matteini, Istituto di Fisica Applicata (Italy)
Fulvio Ratto, Istituto di Fisica Applicata (Italy)
Luca Menabuoni, Unità Operativa Oculistica (Italy)
Ivo Lenzetti, Unità Operativa Oculistica (Italy)
Sonia H. Yoo, Univ. of Miami Miller School of Medicine (United States)
Jean-Marie Parel, Univ. of Miami Miller School of Medicine (United States)

Published in SPIE Proceedings Vol. 6844:
Ophthalmic Technologies XVIII
Bruce E. Stuck; Fabrice Manns; Per G. Söderberg; Michael Belkin M.D.; Arthur Ho, Editor(s)

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