Quality of corneal lamellar cuts quantified using atomic force microscopy

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To quantify the cut quality of lamellar dissections made with the femtosecond laser using atomic force microscopy (AFM). Setting: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. Design: Experimental study. Methods: Experiments were performed on 3 pairs of human cadaver eyes. The cornea was thinned to physiologic levels by placing the globe, cornea side down, in 25% dextran for 24 hours. The eyes were reinflated to normal pressures by injecting a balanced salt solution into the vitreous cavity. The eyes were placed in a holder, the epithelium was removed, and the eyes were cut with a Visumax femtosecond laser. The energy level was 180 nJ for the right eye and 340 nJ for the left eye of each pair. The cut depths were 200 μm, 300 μm, and 400 μm, with the cut depth maintained for both eyes of each pair. A 12.0 mm trephination was then performed. The anterior portion of the lamellar surface was placed in a balanced salt solution and imaged with AFM. As a control, the posterior surface was placed in 2% formalin and imaged with environmental scanning electron microscopy (SEM). Four quantitative parameters (root-mean-square deviation, average deviation, skewness, kurtosis) were calculated from the AFM images. Results: From AFM, the 300 μm low-energy cuts were the smoothest. Similar results were seen qualitatively in the environmental SEM images. Conclusion: Atomic force microscopy provided quantitative information on the quality of lamellar dissections made using a femtosecond laser, which is useful in optimizing patient outcomes in refractive and lamellar keratoplasty surgeries. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Original languageEnglish
Pages (from-to)110-117
Number of pages8
JournalJournal of Cataract and Refractive Surgery
Volume39
Issue number1
DOIs
StatePublished - Jan 1 2013

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Atomic Force Microscopy
Lasers
Electron Scanning Microscopy
Cornea
Dissection
Salts
Trephining
Corneal Transplantation
Disclosure
Dextrans
Cadaver
Formaldehyde
Research Design
Epithelium
Medicine
Pressure

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Surgery

Cite this

Quality of corneal lamellar cuts quantified using atomic force microscopy. / Ziebarth, Noel Marysa; Dias, Janice; Hürmeriç, Volkan; Abou Shousha, Mohamed; Yau, Chiyat Ben; Moy, Vincent T.; Culbertson, William W; Yoo, Sonia H.

In: Journal of Cataract and Refractive Surgery, Vol. 39, No. 1, 01.01.2013, p. 110-117.

Research output: Contribution to journalArticle

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title = "Quality of corneal lamellar cuts quantified using atomic force microscopy",
abstract = "Purpose: To quantify the cut quality of lamellar dissections made with the femtosecond laser using atomic force microscopy (AFM). Setting: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. Design: Experimental study. Methods: Experiments were performed on 3 pairs of human cadaver eyes. The cornea was thinned to physiologic levels by placing the globe, cornea side down, in 25{\%} dextran for 24 hours. The eyes were reinflated to normal pressures by injecting a balanced salt solution into the vitreous cavity. The eyes were placed in a holder, the epithelium was removed, and the eyes were cut with a Visumax femtosecond laser. The energy level was 180 nJ for the right eye and 340 nJ for the left eye of each pair. The cut depths were 200 μm, 300 μm, and 400 μm, with the cut depth maintained for both eyes of each pair. A 12.0 mm trephination was then performed. The anterior portion of the lamellar surface was placed in a balanced salt solution and imaged with AFM. As a control, the posterior surface was placed in 2{\%} formalin and imaged with environmental scanning electron microscopy (SEM). Four quantitative parameters (root-mean-square deviation, average deviation, skewness, kurtosis) were calculated from the AFM images. Results: From AFM, the 300 μm low-energy cuts were the smoothest. Similar results were seen qualitatively in the environmental SEM images. Conclusion: Atomic force microscopy provided quantitative information on the quality of lamellar dissections made using a femtosecond laser, which is useful in optimizing patient outcomes in refractive and lamellar keratoplasty surgeries. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.",
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