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Corneal lathing using the excimer laser and a computer-controlled positioning system.

R Biowski1, P Homolka, T Barisani-Asenbauer

  • 1Department of Ophthalmology, University of Vienna, Medical School, Austria.

Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|February 29, 2000
PubMed
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The excimer laser corneal shaping system (ELCS-S) offers computer-controlled preparation of corneal grafts. This novel system provides precise, sterile corneal tissue for transplantation, potentially improving outcomes compared to existing methods.

Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Surgical Technology

Background:

  • Current methods for preparing corneal grafts for transplantation can be limited in precision and sterility.
  • The development of advanced laser technologies offers potential for improved tissue preparation.

Purpose of the Study:

  • To introduce the excimer laser corneal shaping system (ELCS-S), an accessory for the Schwind Keratom excimer laser.
  • To evaluate the system's capability in preparing donor corneas for various grafting procedures.

Main Methods:

  • The ELCS-S utilizes a 193-nm excimer laser for computer-designed corneal tissue preparation.
  • Surgeons or technicians can design lenticules for lamellar grafts and buttons for penetrating keratoplasty.
  • The system operates under sterile conditions for enhanced safety and flexibility.

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Main Results:

  • Excimer laser corneal shaping system (ELCS-S) produced epikeratoplasty lenticules with minimal surface irregularities.
  • Transmission electron microscopy showed a superficial damage zone of less than 0.3 micrometers.
  • Final graft thickness was accurate to within +/-53 micrometers of the programmed value.
  • Penetrating keratoplasty buttons had smooth stromal surfaces with minimal Descemet's membrane protrusion and limited adjacent endothelial injury (40-100 micrometers).

Conclusions:

  • The ELCS-S enables precise, surgeon-designed, sterile preparation of corneal grafts using excimer laser technology.
  • This system presents significant advantages over current techniques for lamellar dissection and trephination in corneal transplantation.