Noncontact laser photothermal keratoplasty II: Refractive effects and treatment parameters in cadaver eyes

G. Simon, Q. Ren, J. M. Parel

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

BACKGROUND: Noncontact laser photothermal keratoplasty may provide a new alternative for the treatment of myopia, hyperopia, and astigmatism. The purpose of this article is to study the refractive effect that laser photoablation keratoplasty is capable of producing on a normal human cadaver cornea, including the relationship between the keratometric changes and laser treatment parameters. METHODS: The human cadaver eyes were treated with a holmium laser (pulsed Ho:YAG, 2.10 μm, 250 μs) coupled to a maskable, polyprismatic delivery system mounted on either an optical bench or a slit- lamp microscope. Using a topographic videokeratography system, we first investigated the refractive effect that noncontact laser photothermal keratoplasty would produce on a normal cadaver cornea. We then studied the keratometric changes produced by different radiant exposure levels at a fixed treatment pattern, as well as by different treatment patterns at a fixed radiant exposure level. Finally, we studied the possible therapeutic application of laser photothermal keratoplasty for correcting high postoperative astigmatism on a cadaver eye model. RESULTS: For the single- pulse 3-millimeter ring of eight-spot treatment, the keratometric power of the cornea initially increased with the radiant exposure and peaked at 26 J/cm2. The refractive effect was increased by projecting an additional set of eight spots equidistant between the first eight spots on the same diameter ring. Eighteen J/cm2 was the minimal radiant exposure required to produce consistent and predictable keratometric changes. The corneas were flattened using treatment patterns smaller than or equal to 3 mm in diameter and steepened using treatment patterns larger than or equal to 5 mm in diameter. A transition zone between 4 and 5 mm was observed in which minimal and unpredictable keratometric changes of the central cornea occurred. The surgically-induced astigmatism (>10.00 D) was corrected by progressive laser photothermal keratoplasty treatments. CONCLUSIONS: Laser photothermal keratoplasty can acutely steepen and flatten the cornea in human cadaver eyes.

Original languageEnglish (US)
Pages (from-to)519-528
Number of pages10
JournalJournal of Refractive and Corneal Surgery
Volume10
Issue number5
StatePublished - Jan 1 1994
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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