title: Corneal endothelial viability after femtosecond laser preparation of posterior lamellar discs for Descemet-stripping endothelial keratoplasty.
abstract: OBJECTIVE
  To evaluate the feasibility of the femtosecond (FS) laser in preparation of posterior lamellar discs (PLDs) and to study the effect on endothelial cell (EC) viability for Descemet-stripping endothelial keratoplasty.
  
  
  METHODS
  Fourteen human donor bulbi unsuitable for transplantation were used. A horizontal lamellar cut was prepared in the donor cornea with an FS laser by using a raster and/or a spiral spot pattern. The control group consisted of the paired cornea of the same donor. EC density was evaluated before and after preservation in organ culture. The PLD was stripped from the anterior part by using either a forceps or a blunt dissection technique. The damage to the endothelium was evaluated.
  
  
  RESULTS
  EC loss after organ storage was not statistically significant between the FS cornea group and the control group in the 15- (7.7% +/- 6.9% and 8.9% +/- 8.1%, respectively; P = 0.78) and 30-kHz (4.3% +/- 4.0% and 3.7% +/- 3.6%, respectively; P = 0.75) group. There was no significant effect of laser frequency (15 vs. 30 kHz) on EC loss (7.7% vs. 4.3%, P = 0.25). Dissection by using a forceps stripping technique resulted in higher EC loss than that with a blunt dissection technique (13.0% vs. 6.5%, P = 0.03).
  
  
  CONCLUSIONS
  EC loss after FS laser lamellar cutting is not dependent on the frequency (ie, energy level) of the laser. A blunt dissection technique of PLDs resulted in acceptable EC loss and supports the clinical use of the FS laser for the preparation of PLDs.
authors: Department of Ophthalmology, University Hospital Maastricht, Maastricht, The Netherlands.
authors: Yanny Y Y
authors: YY
authors: Cheng
authors: Elisabeth
authors: E
authors: Pels
authors: Jack P M
authors: JP
authors: Cleutjens
authors: Robert J
authors: RJ
authors: van Suylen
authors: Fred
authors: F
authors: Hendrikse
authors: Rudy M M A
authors: RM
authors: Nuijts
mesh_terms: D000368:Aged; D002452:Cell Count; D002470:Cell Survival; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000473:pathology* / Q000637:transplantation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D009924:Organ Culture Techniques