We used the ArF excimer laser to determine the feasibility of performing prismatic photoablations in model eyes (plastic spheres simulating the eye), and in rabbit corneas. This would correct diplopia and small angles of deviation, and result in minimal refractive alterations. We modified excimer laser delivery system that achieved the desired corneal contour of prismatic ablations. 193-nm argon fluoride laser was used at fluence of 160 mJ/cm2 and ablation rate 5 Hz. 5.0-mm diameter, 40 um corneal epithelial ablation were followed by 5.0- mm diameter, prismatic photokeratectomy (PPK). We were able to achieve prismatic photoablation of PMMA blocks and lenses. No other refractive changes accompanied the prismatic photoablation of PMMA blocks and lenses. No other refractive changes accompanied the prismatic effect. In rabbits re-epithelialization of the 5-mm ablations was complete by day 3, and corneal haze was not observed by gross examination. Epithelial hyperplasia and subepithelial scarring were noted at the deep edges. PPK holds important therapeutic potential for fine-tuning results of conventional strabismus surgery, and for patients with stable diplopia following nerve palsy and ocular surgery.
Dimitri T. Azar,
"New excimer laser technique for the correction of strabismus and diplopia", Proc. SPIE 2126, Ophthalmic Technologies IV, (23 June 1994); doi: 10.1117/12.178589; https://doi.org/10.1117/12.178589