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Related Experiment Video

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Femtosecond-Assisted Big Bubble: A Feasibility Study.

Vasilios F Diakonis1, Sonia H Yoo, Victor Hernandez

  • 1*Department of Cornea, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL;†Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL; and‡Department of Ocular Pathology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL.

Cornea
|September 24, 2016
PubMed
Summary

Femtosecond laser-assisted (FA) tunnel creation is a feasible pretreatment for creating a big bubble (BB) to separate corneal stroma from Descemet membrane. This technique successfully achieved complete stromal-Descemet membrane separation in all tested human cadaver corneas.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Laser Technology

Background:

  • Deep anterior lamellar keratoplasty (DALK) requires precise separation of corneal layers.
  • Creating a big bubble (BB) is crucial for pneumo-dissection in DALK.
  • Current methods for BB creation can be challenging.

Purpose of the Study:

  • To assess the feasibility of femtosecond laser-assisted (FA) tunnel creation as a pretreatment.
  • To evaluate FA pretreatment for facilitating big bubble (BB) formation.
  • To achieve pneumo-dissection of corneal stroma from Descemet membrane.

Main Methods:

  • Five human cadaver eyes underwent femtosecond laser pretreatment to create intrastromal tunnels and side cuts.
  • Optical coherence tomography (OCT) guided tunnel orientation parallel to the endothelium.
  • Pneumo-dissection using a DALK cannula was performed after tunnel creation.

Main Results:

  • FA pretreatment was successful in all 5 cadaver corneas.
  • Big bubble (BB) formation was achieved in all eyes.
  • Histology confirmed complete separation of Descemet membrane and stroma without perforation.

Conclusions:

  • Femtosecond laser-assisted big bubble (FABB) creation appears feasible for corneal stromal dissection.
  • The technique demonstrated successful and complete separation of Descemet membrane and stroma.
  • OCT and histological analysis support the efficacy of this pretreatment method.