title: Femtosecond laser cutting of multiple thin corneal stromal lamellae for endothelial bioengineering.
abstract: OBJECTIVE
  To assess the feasibility of cutting multiple thin stromal lamellae in human donor corneas using a commercial femtosecond laser (FSL) to provide cell carriers for future endothelial graft bioengineering.
  
  
  METHODS
  Eight edematous organ-cultured corneas not suitable for grafting for endothelial reasons were mounted on a Ziemer anterior chamber and cut with a Z6 FSL with 6 successive parallel cuts, from depth to surface. Target thickness of each lamella ranged from 100 to 150 μm depending on initial corneal thickness. Thickness was measured using anterior segment optical coherence tomography before and after cutting on mounted corneas, and on each stromal lamella after detachment. Scanning electron microscopy observation was performed on 4 lamellae and histological cross sections on 1 cornea before detachment.
  
  
  RESULTS
  A median of 5 (minimum 3, maximum 7) lamellae was obtained per cornea. All lamellae still attached were the most posterior ones, suggesting that FSL was less efficient because of light scattering by edematous stroma. Cut precision and postdetachment swelling were correlated with anterior-posterior position within the cornea. Median lamella thickness was 127 μm (56-222 μm) before detachment and 196 μm (80-304 μm) after detachment. Surface state was consistent with previously reported FSL lamellar cuts during Descemet stripping automated endothelial keratoplasty.
  
  
  CONCLUSIONS
  Up to 7 thin lamellae can be cut in stored corneas with an FSL. This method, once optimized primarily by using deswelled, more transparent corneas, could prove effective for recycling unsuitable donor corneas in corneal bioengineering processes.
authors.affiliation: *Corneal Graft Biology, Engineering and Imaging Laboratory, Federative Institute of Research in Sciences and Health Engineering, Jean Monnet University, Saint-Etienne, France; †Department of Pathology, University Hospital, Saint-Etienne, France; ‡Department of Ophthalmology, University Hospital, Besançon, France; §Eye Bank of Saint-Etienne, Auvergne Loire Blood Center, Saint-Etienne, France; ¶Department of Ophthalmology, University Hospital, Saint-Etienne, France; and ‖Institut Universitaire de France, Boulevard Saint-Michel, Paris, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Bernard
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: He
authors.forename: Fabien
authors.initials: F
authors.lastname: Forest
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Gauthier
authors.forename: Michel
authors.initials: M
authors.lastname: Peocʼh
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Dumollard
authors.forename: Sophie
authors.initials: S
authors.lastname: Acquart
authors.forename: Romain
authors.initials: R
authors.lastname: Montard
authors.forename: Bernard
authors.initials: B
authors.lastname: Delbosc
authors.forename: Philippe
authors.initials: P
authors.lastname: Gain
authors.forename: Gilles
authors.initials: G
authors.lastname: Thuret
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003319:Corneal Stroma / Q000601:surgery* / Q000648:ultrastructure; D004728:Endothelium, Corneal / Q000637:transplantation; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008855:Microscopy, Electron, Scanning; D009924:Organ Culture Techniques; D009929:Organ Size; D013524:Surgical Flaps / Q000473:pathology*; D014019:Tissue Donors; D023822:Tissue Engineering; D041623:Tomography, Optical Coherence