Combining femtosecond laser ablation and diode laser welding in lamellar and endothelial corneal transplants

Roberto Pini, Francesca Rossi, Paolo Matteini, Fulvio Ratto, Luca Menabuoni, Ivo Lenzetti, Sonia H. Yoo, Jean Marie Parel

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Scopus citations

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 μm 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 μm diameter. Femtosecond laser sculpturing of the donor cornea provided lamellar and endothelial flaps of preset and constant thickness. Diode laser-induced welding showed a unique potential to permanently secure the donor flap in place, avoiding postoperative displacement and inflammation reaction.

Original languageEnglish (US)
Title of host publicationOphthalmic Technologies XVIII
DOIs
StatePublished - May 26 2008
EventOphthalmic Technologies XVIII - San Jose, CA, United States
Duration: Jan 19 2008Jan 21 2008

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume6844
ISSN (Print)1605-7422

Other

OtherOphthalmic Technologies XVIII
CountryUnited States
CitySan Jose, CA
Period1/19/081/21/08

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Keywords

  • Cornea
  • Corneal transplant
  • Diode laser
  • Femtosecond laser
  • Indocyanine Green
  • Laser welding

ASJC Scopus subject areas

  • Engineering(all)

Cite this

Pini, R., Rossi, F., Matteini, P., Ratto, F., Menabuoni, L., Lenzetti, I., Yoo, S. H., & Parel, J. M. (2008). Combining femtosecond laser ablation and diode laser welding in lamellar and endothelial corneal transplants. In Ophthalmic Technologies XVIII [684411] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 6844). https://doi.org/10.1117/12.762945