Nonmechanical Q-switched erbium:YAG laser trephination for penetrating keratoplasty: experimental study on human donor corneas

Stojkovic, M.; Küchle, M.; Seitz, B.; Langenbucher, A.; Viestenz, A.; Viestenz, A.; Hofmann-Rummelt, C.; Schlötzer-Schrehardt, U.; Naumann, G.O.H.

Archives of Ophthalmology 121(10): 1415-1422

2003


ISSN/ISBN: 0003-9950
PMID: 14557177
DOI: 10.1001/archopht.121.10.1415
Accession: 012361105

Download citation:  
Text
  |  
BibTeX
  |  
RIS

Article/Abstract emailed within 0-6 h
Payments are secure & encrypted
Powered by Stripe
Powered by PayPal

Abstract
Objective: To assess the alterations in human donor corneal tissue induced by Q-switched erbium (Er):YAG laser corneal trephination. Methods: Thirty human corneoscleral donor buttons unsuitable for transplantation were placed in an artificial chamber on an automated rotation device. Corneas were trephined with a Q-switched Er:YAG laser (wavelength, 2.94 mum; pulse duration, 400 nanoseconds) along (donor and recipient) aluminum silicate (ceramic) open masks. A spot diameter of 0.65 mm, energy setting of 50 mJ/pulse, and repetition rate of 5 Hz were used. Corneal thermal damage and cut regularity were quantitatively assessed in 24 corneas processed for light microscopy and by transmission and scanning electron microscopy. Results: The stromal thermal damage was the highest (mean (SD), 8.0 (2.7) mum) at a 150-mum cut depth and decreased downward. Cut regularity was very good and did not significantly differ between donors and recipients. Scanning electron microscopy confirmed that the cuts were highly regular; transmission electron microscopy revealed 2 distinctive subzones within the stromal thermal damage zone. Conclusions: Thermal damage induced by Q-switched Er:YAG nonmechanical corneal trephination was low, and the regularity of the cuts was very good. Clinical Relevance: The Q-switched Er:YAG laser may have the potential to become an alternative to the excimer laser for nonmechanical penetrating keratoplasty.

Nonmechanical Q-switched erbium:YAG laser trephination for penetrating keratoplasty: experimental study on human donor corneas