9 March 2012 "All-laser" endothelial corneal transplant in human patients
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Proceedings Volume 8209, Ophthalmic Technologies XXII; 82091O (2012) https://doi.org/10.1117/12.907941
Event: SPIE BiOS, 2012, San Francisco, California, United States
Femtosecond laser sculpturing of corneal tissue is commonly used for the preparation of endothelial flaps. Diode laser welding of ocular tissues is a procedure that enables minimally invasive suturing of tissues. The combination of these laser based techniques results in a new approach to minimally invasive ophthalmic surgery, such as in endothelial corneal transplant (or endothelial keratoplasty - EK). In this work we present the "all laser" EK performed in human subjects. 24 pseudophakic patients with bullous keratopathy underwent EK: the femtosecond laser was used to prepare the 100 ìm thick and 8.5 mm diameter donor Descemet endothelial flap. After staining the stromal layer of the donor flap with a liquid ICG solution, the donor flap was inserted in the recipient eye by the use of the Busin injector. Then, the endothelial layer was laser-welded to the recipient eye (10 laser spots around the periphery of the flap), in order to reduce the risk of postoperative dislocation of the transplanted flap. A transplanted flap engraftment was observed in all the treated eyes. The staining procedure used to perform laser welding also enabled to evidence the stromal side of the donor flap, so as the flap was always placed in the right side position. The endothelial cells counts in both the laserwelded flaps and in a control group were in good agreement. The proposed technique is easy to perform and enables the reduction of postoperative endothelial flap dislocations.
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Francesca Rossi, Francesca Rossi, Luca Menabuoni, Luca Menabuoni, Alex Malandrini, Alex Malandrini, Annalisa Canovetti, Annalisa Canovetti, Ivo Lenzetti, Ivo Lenzetti, Roberto Pini, Roberto Pini, ""All-laser" endothelial corneal transplant in human patients", Proc. SPIE 8209, Ophthalmic Technologies XXII, 82091O (9 March 2012); doi: 10.1117/12.907941; https://doi.org/10.1117/12.907941

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