title: Laser welding in penetrating keratoplasty and cataract surgery in pediatric patients: early results.
abstract: OBJECTIVE
  To evaluate the efficacy of diode laser welding to close corneal wounds in penetrating keratoplasty (PKP) and cataract surgery in pediatric patients.
  
  
  METHODS
  Ophthalmology Department, Bambino Gesù Children's Hospital, Rome, Italy.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Patients had surgery for congenital cataract (Group 1) or femtosecond laser-assisted PKP (Group 2). The surgery was followed by corneal wound closure using diode laser welding of the stroma. In Group 1, no standard suturing was used. In Group 2, the donor button was sutured onto the recipient using 8 single nylon sutures or a 10-0 nylon running suture (12 passages). Laser welding was then used as an adjunct to the traditional suturing procedure.
  
  
  RESULTS
  Group 1 comprised 7 eyes (7 patients; mean age 8.1 years ± 5.3 [SD], range 1 to 15 years) and Group 2, 5 eyes (5 patients; mean age 10.6 ± 3.3 years, range 6 to 15 years). The adhesion of the laser-welded tissues was perfect; there were no collateral effects, and restoration of the treated tissues was optimum. Seidel testing showed no wound leakage during the follow-up. Postoperative astigmatism did not change significantly from the first day after cataract surgery and shifted moderately 3 months after PKP.
  
  
  CONCLUSIONS
  Laser welding of corneal tissue appeared to be safe and effective in children for whom a sutureless surgical procedure is important to reduce the use of anesthesia for suture management, prevent endophthalmitis, and improve the antiamblyopic effect.
authors.affiliation: From the Ophthalmology Departments, Bambino Gesù Children's Hospital (Buzzonetti, Capozzi, Petrocelli, Valente, Petroni), IRCCS, Rome, and Misericordia e Dolce Hospital (Menabuoni), Prato, and Istituto di Fisica Applicata Nello Carrara (Rossi, Pini), Italian National Research Council, Sesto Fiorentino, Florence, Italy. Electronic address: lucabuzzonetti@yahoo.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Buzzonetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Capozzi
authors.forename: Gianni
authors.initials: G
authors.lastname: Petrocelli
authors.forename: Paola
authors.initials: P
authors.lastname: Valente
authors.forename: Sergio
authors.initials: S
authors.lastname: Petroni
authors.forename: Luca
authors.initials: L
authors.lastname: Menabuoni
authors.forename: Francesca
authors.initials: F
authors.lastname: Rossi
authors.forename: Roberto
authors.initials: R
authors.lastname: Pini
mesh_terms: D000293:Adolescent; D001251:Astigmatism / Q000503:physiopathology; D002386:Cataract / Q000151:congenital; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D003318:Corneal Opacity / Q000601:surgery; D003319:Corneal Stroma / Q000601:surgery*; D006801:Humans; D007223:Infant; D007640:Keratoconus / Q000601:surgery; D015948:Keratoplasty, Penetrating; D017075:Laser Coagulation / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome