Potential use of lasers for penetrating keratoplasty

Keith P. Thompson, Elena Barraquer, Jean Marie Parel, Hanspeter Loertscher, Stephen Pflugfelder, Thomas Roussel, Simon Holland, Khalil Hanna

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Experimental corneal trephination has been achieved with the 193 nm argon fluoride excimer and 2.9 μm hydrogen fluoride and Er:YAG laser systems. Compared with metal blades and other lasers, the 193 nm excimer laser creates the best quality corneal excision, but has a relatively slow etch rate through the stroma, and its use requires toxic gas. The mid-infrared laser systems trephine the cornea in less than 10 seconds, but cause a 10 μm to 15 μm zone of adjacent stromal damage and create wounds that are approximately 2.5 times larger than wounds made by metal scalpels. The wavelengths and laser pulse duration influence the cutting characteristics of the laser. Optical delivery systems using an axicon lens, a rotating slit, and a computer controlled scanning optical system have been developed for penetrating keratoplasty. Selection of the optimal laser system for penetrating keratoplasty must await further experimental studies. Refinements of the laser cavity and delivery system are necessary before clinical studies can begin. A carefully controlled randomized clinical trial comparing laser trephination with conventional mechanical trephines will be necessary to determine the safety and efficacy of a laser trephination system.

Original languageEnglish (US)
Pages (from-to)397-403
Number of pages7
JournalJournal of cataract and refractive surgery
Issue number4
StatePublished - 1989


  • laser
  • penetrating keratoplasty
  • postoperative astigmatism
  • trephine

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems


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