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Interface quality of endothelial keratoplasty buttons obtained with optimised femtosecond laser settings
  1. Antoine Rousseau1,
  2. Abdelkader Bensalem2,
  3. Virginie Garnier3,
  4. Michèle Savoldelli1,4,
  5. Jean-Jacques Saragoussi1,5,
  6. Gilles Renard6,
  7. Jean-Louis Bourges6
  1. 1Assistance Publique-Hôpitaux de Paris, Department of Ophthalmology, Hôtel-Dieu Hospital, Paris, France
  2. 2Abbott Medical Optics France SAS, Biot, France
  3. 3Pierre et Marie Curie University, Department of Electron Microscopy, Institut de Biologie Intégrative IFR 83, Paris, France
  4. 4INSERM U872 team 17, CRC des Cordeliers, Paris, France
  5. 5Clinique de la Vision, Paris, France
  6. 6Université Sorbonne Paris Cité, Paris Descartes, Faculty of Medicine, Assistance Publique-Hôpitaux de Paris, Department of Ophthalmology, Hôtel-Dieu Hospital, Paris, France
  1. Correspondence to Dr Jean-Louis Bourges, Department of Ophthalmology, Hôtel-Dieu Hospital, 1 place du parvis Notre-Dame, 75004 Paris, France; jean-louis.bourges{at}htd.aphp.fr

Abstract

Aim To optimise interfaces of endothelial buttons created with femtosecond (FS) lasers.

Setting Department of Ophthalmology, Hôtel-Dieu Hospital, Paris, France.

Methods Forty-two corneas were divided into five groups of various cutting patterns and a control group of 100 μm laser in situ keratomileusis flap creation. A single path full lamellar cut (500 μm) was applied to groups 1 and 2. The same full lamellar cut was applied twice to groups 3 and 4. Two successive lamellar cuts were performed in group 5 (350 and 150 μm). 60 kHz and 150 kHz were used respectively in groups 1, 3, 5, 6 and 2, 4. In each group, different laser settings were tested to obtain the best interface quality while delivering minimal energy to the stroma. The quality of stromal interfaces from created endothelial lenticules was observed using a scanning electron microscope.

Results Stromal adherences persisted after both the single- and double-path procedure, creating central irregularities on the endothelial lenticule. Among all groups and settings tested, the double-layer pattern (group 5) with FS full lamellar cut parameters set for diameter (mm), depth (μm), energy (μJ) and spot size/step (μm) respectively on 9.0 mm, 350 μm, 2.1 μJ, 4:4 μm and 8.3 mm, 150 μm, 0.9 μJ, 4:4 μm created the smoothest interfaces with the best reproducibility.

Conclusions Buttons for endothelial keratoplasty can be created with FS laser with a stromal interface quality comparable with that of refractive surgery.

  • endothelial keratoplasty
  • femtosecond laser
  • Descemet stripping endothelial keratoplasty (DSEK)
  • lenticule
  • cornea
  • sclera and episclera
  • treatment lasers
  • experimental and laboratory
  • dystrophy
  • optics and refraction
  • ocular surface
  • experimental and animal models
  • treatment surgery
  • degeneration
  • inflammation
  • medical education
  • wound healing
  • eye (tissue) banking
  • trauma
  • infection
  • anterior chamber

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Footnotes

  • Funding Abbott Medical Optics (AMO France SAS, Biot, France) and the Centre d'Innovation Thérapeutique en Ophtalmologie (CITO) non-profit organisation (Paris, France) both supported in part the present work. AMO graciously provided femtosecond laser procedures. AMO and the CITO co-funded the scanning electron microscopy sessions.

  • Competing interests AB is an employee of Abbott Medical Optics France.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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