The use of the femtosecond laser in penetrating keratoplasty
The use of the femtosecond laser in penetrating keratoplasty
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DOI：
10.1016/j.ajo.2007.01.056
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发表时间：
2007-05-01
影响因子：
4.2
通讯作者：
Bohm, Elisabetta
中科院分区：
文献类型：
--
作者：
Buratto, Lucio;Bohm, Elisabetta
目的：评估使用飞秒激光新软件算法的穿透性角膜移植术 (PK) 新技术，该算法旨在为治疗多种角膜疾病时的 PK 进行穿透性切割。设计：前瞻性、介入性病例系列。方法：所有眼睛均在意大利翁贝托市的 Ospedale Civile di Mestre 医院接受治疗。使用 15 kHz 飞秒激光（IntraLase，尔湾，加利福尼亚州，美国）和专门为角膜手术开发的新软件，对 7 名患者的 7 只眼睛进行了 PK 手术。在这七名患者中，五名是圆锥角膜患者，两名是大疱性角膜病。新软件用于在礼帽或蘑菇结构中创建穿透切口。手术后，对所有患者进行测厚、角膜地形图、屈光、眼压测量和角膜光学相干断层扫描（Visante；Carl Zeiss，Oberkochen，德国）进行评估。 结果：术后第一天，所有七只眼睛的角膜几乎清晰，供体角膜移植到患者角膜上良好。三个月时，所有眼睛都具有清晰的角膜、良好的内皮细胞计数和安静的前房。每个病例的角膜厚度均达到正常。在为期三个月的访视中，对 5 只眼睛进行了拆线手术以调整散光。结论：虽然数量很少，但早期迹象表明，由于供体角膜更贴合并且患者视力恢复更快，使用新的 IntraLase 软件进行角膜手术为 PK 创造了更有利的环境。
PURPOSE: To evaluate a new technique for penetrating keratoplasty (PK) with the use of a new software algorithm for a femtosecond laser that is designed to create penetrating cuts for PK in the treatment of a number of corneal diseases.DESIGN: Prospective, interventional case series.METHODS: All eyes were treated at the Ospedale Civile di Mestre, Umberto, Italy. Seven eyes of seven patients underwent surgery for PK using a 15-kHz femtosecond laser (IntraLase, Irvine, California, USA) and a new software specifically developed for corneal surgery. Of the seven patients, five were keratoconus patients and two had bullous keratopathy. New software was used to create penetrating cuts in a top hat or mushroom configuration. After surgery, all patients were evaluated with pachymetry, corneal topography, refraction, intraocular pressure measurement, and corneal optical coherence tomography (Visante; Carl Zeiss, Oberkochen, Germany).RESULTS: On postoperative day one, all seven eyes had nearly clear corneas with a good graft of the donor corneas to the patients' corneas. At three months, all eyes had clear corneas with good endothelial cell counts and quiet anterior chambers. Normal corneal thickness was achieved in each case. At the three,month visit, suture removal was performed in five eyes to adjust for astigmatism.CONCLUSIONS: Although this is a small number of eyes early indications are that the use of the new IntraLase software for corneal surgery creates a more favorable environment for PK as a result of a better fit of the donor cornea and a quicker visual recovery for patients.