飞秒激光辅助后部板层角膜移植术:眼库保存眼手术方法的初步研究

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To perfect the technique of femtosecond laser-assisted cutting of the lamella r corneal disc in posterior lamellar keratoplasty. Experimental study. The femto second laser was used to make the posterior corneal lamellar interface and treph ine (side) cut in 20 eye bank globes and 9 eye bank corneoscleral buttons. Laser parameters were energy 7.4±0.1 μJ (lamellar cut) and 8.7±0.1 μJ (trephinati on cut), spot size2.4 μm, firingrate 15kHz,and trephination diameter 6.0 to 8.0 mm. The thicknesses of the excised corneal discs were measured with a digital m icrometer and compared with values calculated from the laser treatment parameter s and the preoperative ultrasound pachymetric readings. The cut surfaces were ex amined by light microscopy and scanning electron microscopy. In globes, the corn eal disc was removed from the eye after laser treatment through a blade incision in the peripheral cornea. In corneoscleral buttons, the posterior disc was peel ed off the cornea with forceps after laser treatment on an artificial anterior c hamber device. In simulated transplantation, the excised corneal disc was placed into the posterior stromal bed in 7 globes. The femtosecond laser was successful in making posterior lame llar and trephination cuts in cornea. The cut surfaces were of very good quality with straight, orthogonal edges, albeit with a mild stucco texture of the lamel lar stromal surfaces. In 3 globes, the lamellar surface showed shallow concentri c ridges. The measured thickness of the excised discs was 55±61 μm thicker tha n the preoperatively predicted values. These preliminary studies show that the f emtosecond laser can make nonmechanical cuts for poste-rior lamellar keratoplas ty with relative ease and reliability, thus facilitating the most technically di fficult step in this surgery. The perfect experiment for femtosecond laser-assisted cutting of the lamella r corneal disc in posterior lamellar keratoplasty. Experimental study. The femto second laser was used to make the posterior corneal lamellar interface and trephine (side) cut in 20 eye bank globes and Laser parameters were energy 7.4 ± 0.1 μJ (lamellar cut) and 8.7 ± 0.1 μJ (trephinati on cut), spot size 2.4 μm, firingrate 15 kHz, and trephination diameter 6.0 to 8.0 mm. The thicknesses of the 9 eye bank corneoscleral buttons. excised corneal discs were measured with a digital m icrometer and comparable with values ​​calculated from the laser treatment parameter s and the preoperative ultrasound pachymetric readings. The cut surfaces were ex amined by light microscopy and scanning electron microscopy. In globes, the corn eal disc was removed from the eye after laser treatment through a blade incision in the peripheral cornea. In corneoscleral buttons, the posterior disc was peel ed off the cornea with forceps aft er laser treatment on an artificial anterior c hamber device. In simulated transplantation, the excised corneal disc was placed into the posterior stromal bed in 7 globes. The femtosecond laser was successful in making posterior lame llar and trephination cuts in cornea. The cut surfaces were of very good quality with straight, orthogonal edges, albeit with a mild stucco texture of the lamel lar stromal surfaces. In 3 globes, the lamellar surface showed shallow concentri c ridges. The measured thickness of the excised discs was 55 ± 61 μm thicker tha These preliminary studies show that the f emtosecond laser can make nonmechanical cuts for poste-rior lamellar keratoplas ty with relative ease and reliability, thus facilitating the most technically di fficult step in this surgery.
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