Ultraviolet solid-state laser (213-nm) photorefractive keratectomy: In vivo study

Q. Ren, G. Simon, J. M. Legeais, Jean-Marie A Parel, William W Culbertson, J. Shen, Y. Takesue, M. Savoldelli

Research output: Contribution to journalArticle

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Abstract

Background: The pulsed ultraviolet 213-nm solid-state laser has been demonstrated as an alternative to the gas argon-fluoride 193-nm excimer laser for photorefractive keratectomy (PRK). The authors studied the clinical course and histopathologic changes occurring in rabbit corneas after PRK with a 213-nm solid-state laser. Methods: The 213-nm output of neodymium:YAG frequency-quintupled laser was used to create 5-mm optical zone ablations in seven pigmented rabbit corneas. The radiant exposure was 250 mJ/cm2 delivered through a computer-controlled scanning delivery system with a spot size of 0.5 mm. The target ablation was 4.0 diopters with an estimated ablation depth of 40 μm. A clinical estimate of corneal epithelial healing and stromal haze was made at intervals over the 3-month study period. Animals were killed immediately after ablation, or at 10 days, 1 month, or 3 months after ablation. Corneal tissue was preserved for light microscopy and transmission electron microscopy at each study interval. Results: All corneas re-epithelialized within 10 days postoperatively. Anterior stromal haze was clinically visible at 3 days, increased until approximately 1 month, and then gradually decreased over the succeeding 2 months. Residual subepithelial haze was visible at 3 months. Results of histopathologic study documented normal epithelium healing over time; the basement membrane retained its regular thickness and hemidesmosomes were abundant at 3 months. The anterior stroma had an increased number of fibroblasts at 10 days, many of which remained until 1 month. A mild, transient, cellular reaction occurred throughout the thickness of the stroma and the endothelium. Conclusion: Using the 213-nm ultraviolet solid-state laser with a scanning delivery system, PRK shows a similar clinical course and histopathologic findings to the 193-nm excimer PRK study in rabbits. It is a clinically viable procedure for refractive surgery and requires further human clinical trials to determine its efficacy.

Original languageEnglish
Pages (from-to)883-889
Number of pages7
JournalOphthalmology
Volume101
Issue number5
StatePublished - Jan 1 1994

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Photorefractive Keratectomy
Solid-State Lasers
Cornea
Rabbits
Laser Corneal Surgery
Hemidesmosomes
Neodymium
Refractive Surgical Procedures
Excimer Lasers
Transmission Electron Microscopy
Basement Membrane
Endothelium
Microscopy
Lasers
Epithelium
Fibroblasts
Gases
Clinical Trials
Light

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Ren, Q., Simon, G., Legeais, J. M., Parel, J-M. A., Culbertson, W. W., Shen, J., ... Savoldelli, M. (1994). Ultraviolet solid-state laser (213-nm) photorefractive keratectomy: In vivo study. Ophthalmology, 101(5), 883-889.

Ultraviolet solid-state laser (213-nm) photorefractive keratectomy : In vivo study. / Ren, Q.; Simon, G.; Legeais, J. M.; Parel, Jean-Marie A; Culbertson, William W; Shen, J.; Takesue, Y.; Savoldelli, M.

In: Ophthalmology, Vol. 101, No. 5, 01.01.1994, p. 883-889.

Research output: Contribution to journalArticle

Ren, Q, Simon, G, Legeais, JM, Parel, J-MA, Culbertson, WW, Shen, J, Takesue, Y & Savoldelli, M 1994, 'Ultraviolet solid-state laser (213-nm) photorefractive keratectomy: In vivo study', Ophthalmology, vol. 101, no. 5, pp. 883-889.
Ren, Q. ; Simon, G. ; Legeais, J. M. ; Parel, Jean-Marie A ; Culbertson, William W ; Shen, J. ; Takesue, Y. ; Savoldelli, M. / Ultraviolet solid-state laser (213-nm) photorefractive keratectomy : In vivo study. In: Ophthalmology. 1994 ; Vol. 101, No. 5. pp. 883-889.
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abstract = "Background: The pulsed ultraviolet 213-nm solid-state laser has been demonstrated as an alternative to the gas argon-fluoride 193-nm excimer laser for photorefractive keratectomy (PRK). The authors studied the clinical course and histopathologic changes occurring in rabbit corneas after PRK with a 213-nm solid-state laser. Methods: The 213-nm output of neodymium:YAG frequency-quintupled laser was used to create 5-mm optical zone ablations in seven pigmented rabbit corneas. The radiant exposure was 250 mJ/cm2 delivered through a computer-controlled scanning delivery system with a spot size of 0.5 mm. The target ablation was 4.0 diopters with an estimated ablation depth of 40 μm. A clinical estimate of corneal epithelial healing and stromal haze was made at intervals over the 3-month study period. Animals were killed immediately after ablation, or at 10 days, 1 month, or 3 months after ablation. Corneal tissue was preserved for light microscopy and transmission electron microscopy at each study interval. Results: All corneas re-epithelialized within 10 days postoperatively. Anterior stromal haze was clinically visible at 3 days, increased until approximately 1 month, and then gradually decreased over the succeeding 2 months. Residual subepithelial haze was visible at 3 months. Results of histopathologic study documented normal epithelium healing over time; the basement membrane retained its regular thickness and hemidesmosomes were abundant at 3 months. The anterior stroma had an increased number of fibroblasts at 10 days, many of which remained until 1 month. A mild, transient, cellular reaction occurred throughout the thickness of the stroma and the endothelium. Conclusion: Using the 213-nm ultraviolet solid-state laser with a scanning delivery system, PRK shows a similar clinical course and histopathologic findings to the 193-nm excimer PRK study in rabbits. It is a clinically viable procedure for refractive surgery and requires further human clinical trials to determine its efficacy.",
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