Inverse mushroom-shaped nonmechanical penetrating keratoplasty using a femtosecond laser.
OBJECTIVE
To demonstrate the feasibility of an inverse mushroom-shaped nonmechanical corneal trephination using a femtosecond laser in a noncontact manner.


METHODS
Experimental study.


METHODS
In this laboratory study, 10 polymethylmethacrylate (PMMA) blocks and 20 porcine corneas were treated with an industrial femtosecond laser source. The trephination profile consisted of (1) a 7- or 6-mm diameter cylinder from the anterior chamber, (2) an intermediate horizontal connecting plane, and (3) a concentric 5- or 4-mm diameter cylinder upwards.


RESULTS
Applying appropriate combinations of pulse energy and spacing, trephination took less than 60 seconds. In porcine eyes, light microscopy displayed trephination edges delineated by partly confluent gas bubbles (10-40 mum) with tissue bridges in between. By TEM, the cut edges were lined by a delicate, electron-dense layer (5-40 nm).


CONCLUSIONS
Femtosecond laser technology seems to offer a promising approach towards minimally invasive self-sealing "no-stitch keratoplasty."
Seitz
Berthold
B
Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen, Germany. berthold.seitz@augen.imed.uni-erlangen.de
Brünner
Holger
H
Viestenz
Arne
A
Hofmann-Rummelt
Carmen
C
Schlötzer-Schrehardt
Ursula
U
Naumann
Gottfried O H
GO
Langenbucher
Achim
A
D000363:Agaricales; D000818:Animals; D003315:Cornea / Q000601:surgery* / Q000648:ultrastructure; D005240:Feasibility Studies; D015948:Keratoplasty, Penetrating / Q000295:instrumentation / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D019904:Polymethyl Methacrylate; D013552:Swine
D019904:Polymethyl Methacrylate