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Experimental microablation of choroidal tissue for autologous retinal pigmentepithelium–choroid translocation with the pulsed electron avalanche knife (PEAK-fc)
  1. Felix Treumer,
  2. Benjamin Sattler,
  3. Arnd Bunse,
  4. Alexa Klettner,
  5. Jost Hillenkamp,
  6. Johann Roider
  1. Department of Ophthalmology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
  1. Correspondence to Dr Felix Treumer, Department of Ophthalmology, University Medical Center Schleswig-Holstein, Arnold-Heller Str. 3, Haus 25, D-24105 Kiel, Germany; ftreumer{at}auge.uni-kiel.de

Abstract

Aim To test the microablation of excess graft choroidal tissue with the pulsed electron avalanche knife (PEAK-fc) in an in-vitro model of autologous retinal pigment epithelium (RPE)–choroid translocation.

Methods Choroidal tissue of porcine RPE–choroid explants was ablated with the PEAK-fc. Tissue morphology was assessed by light microscopy (LM) and scanning electron microscopy (SEM). The amount of ablated choroidal tissue was analysed as a function of three PEAK-fc parameters: (1) amplitude of biphasic voltage (70–100%); (2) distance between choroidal tissue and tip of the PEAK-fc (0–300 μm); and (3) exposure time (2–8 s).

Results LM and SEM showed a smooth plain within the ablation area with well defined cutting edges and preserved adjacent tissue structure. The mean amount of ablated tissue correlated linearly with applied voltage (range 79–120 μm, r=0.34) and distance between choroidal tissue and PEAK-fc tip (range 10–100 μm, r=0.74). The mean amount of ablated tissue increased with exposure time between 2 and 4 s (36–88 μm, r=0.4) and remained constant between 4 and 8 s.

Conclusion The PEAK-fc accurately microablates choroidal tissue in-vitro. The adjacent choroidal tissue structure and Bruch's membrane are preserved. Patient studies are required to test the PEAK-fc in RPE–choroid translocation surgery.

  • RPE transplantation
  • pulsed electron avalanche knife PEAK-fc
  • choroidal ablation
  • AMD
  • choroid
  • retina
  • macula
  • degeneration
  • treatment surgery

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Footnotes

  • Competing interests None.

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