A Comparison of Corneal Cellular Responses After 213-nm Compared With 193-nm Laser Photorefractive Keratectomy in Rabbits

Sanders, T.E.; Pujara, Tarak; Camelo, Serge; Lai, Ching Tat; Saarloos, P. Van; Beazley, Lyn; Rodger, Jennifer

doi:10.1097/ico.0b013e31818c2c89

Cited by 4 publications

(7 citation statements)

References 25 publications

(30 reference statements)

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“…In vivo studies have shown that the 213 nm laser provides advantages in the form of a more controlled ablation site and better stability in cell numbers, implying a more predictable ablation outcome. In vitro , higher levels of superoxide dismutase (SOD) in corneal keratocytes irradiated with 213 nm suggest a better endogenous protection against free radicals induced by laser surgery [9]. Enucleated rabbit eyes that underwent myopic PRK using both excimer laser and solid-state laser systems showed a smooth ablation surface with no edema or distortion to adjacent corneal tissue, indicating absence of thermal damage [10].…”

Section: Discussionmentioning

confidence: 99%

“…A smaller spot size of 0.6 mm, which is 2.5 times smaller than a typical excimer laser spot size, contributes less mechanical stress on the cornea causing less damage to the corneal structure [8, 12]. Histopathologic evidence has demonstrated a more favorable response after irradiation with 213 nm wavelength which may provide a more predictable wound healing and refractive response [9]. Furthermore, the 213 nm wavelength solid-state laser has been proven to be less sensitive to corneal hydration, limiting its effect on the final refractive outcome [13].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Followup of LaserIn SituKeratomileusis for Hyperopia Using a 213 nm Wavelength Solid-State Laser

Quito

Agahan

Evangelista³

2013

ISRN Ophthalmology

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Purpose. To evaluate the long-term efficacy, accuracy, stability, and safety of hyperopic laser in situ keratomileusis (LASIK) using a 213 nm wavelength solid-state laser. Methods. This prospective noncomparative case series consisted of 34 eyes of 17 patients which underwent hyperopic LASIK using a 213 nm solid-state laser (Pulzar Z1, CustomVis) at an outpatient refractive surgery center in Manila, Philippines. The preoperative and postoperative examinations included uncorrected distance visual acuity (UDVA), subjective manifest refraction, corrected distance visual acuity (CDVA), cycloplegic refraction, slitlamp biomicroscopy, and keratometry (K). Main Outcome Measures. Accuracy, efficacy, stability, and safety of the refractive procedure. Results. Mean follow-up was 25.18 ± 13.79 months. At the end of follow-up, 26.47% had a UDVA of 20/20 and 94.12% had a UDVA of ≥20/40. Manifest refractive spherical equivalent (MRSE) was within ±0.50 D of the target refraction in 55.88% and within ±1.0 D in 85.30% of the study eyes. Refractive stability was noted in the 1st postoperative month while hyperopic regression was noted after the 3rd postoperative year. No eye lost more than 2 lines of CDVA. Conclusion. Our results show that the 213 nm solid state laser system is safe, effective, accurate, and predictable for the treatment of hyperopia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Followup of LaserIn SituKeratomileusis for Hyperopia Using a 213 nm Wavelength Solid-State Laser

Quito

Agahan

Evangelista³

2013

ISRN Ophthalmology

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“…With the development and growing use of the 213 nm solid-state laser, published studies [12–14] have suggested that despite the known differences in their ablation characteristics, clinical results in efficacy and safety have been comparable. In a study by Sanders et al, the authors showed that cellular responses after irradiation with 213 nm compared with 193 nm wavelengths are consistent with good clinical outcomes [11]. However, laser ablation of a LASIK flap presents unique problems because of delayed epithelial healing and remodeling as well as stromal changes that may have resulted from previous denervation [15].…”

Section: Discussionmentioning

confidence: 99%

“…It could not be established yet whether 213 nm laser is more cytotoxic and/or mutagenic compared to 193 nm laser because of limited data. However, several studies have proven that corneal ablation by both 213 nm and 193 nm wavelengths produces minimal DNA damage and free radical formation [10, 11]. The 213 nm has also been determined to deliver less energy on the ablation surface, therefore producing less thermal effect than the 193 nm laser [10].…”

Section: Introductionmentioning

confidence: 99%

Photorefractive Keratectomy with Adjunctive Mitomycin C for Residual Error after Laser-Assisted In Situ Keratomileusis Using the Pulzar 213 nm Solid-State Laser: Early Results

Ng-Darjuan¹,

Evangelista²,

Agahan

2013

ISRN Ophthalmology

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Purpose. To evaluate the accuracy, efficacy, stability, and safety of photorefractive keratectomy (PRK) enhancement using the Pulzar 213 nm solid-state laser (SSL) with adjunctive Mitomycin C in eyes previously treated with laser assisted in situ keratomileusis (LASIK) with residual error of refraction. Methods. This is a prospective noncomparative case series of 16 eyes of 12 patients who underwent PRK for residual refractive error after primary LASIK. Mitomycin C 0.02% was used after the PRK to prevent haze formation. Outcomes measured were pre- and postoperative manifest refraction spherical equivalent (MRSE), uncorrected (UDVA) and best-corrected distance visual acuity (CDVA), and slit lamp evidence of corneal complications. Results. The mean UDVA improved from 20/70 preoperatively to 20/30 postoperatively. The average gain in lines for the UDVA was 2.38. After six months of followup, the postoperative MRSE within 0.50 D in 56% (9) of eyes and 94% (15) eyes were within 1.0 diopters of the intended correction. No eyes developed haze all throughout the study. Conclusion. PRK enhancement with adjunctive use of Mitomycin C for the correction of residual error of refraction after LASIK using the Pulzar 213 nm solid-state laser is an accurate, effective, and safe procedure.

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“…Current research on corneal wound healing mainly focuses on lasers in the ultraviolet wavelength region, such as 193, [2][3][4] 213, 5,6 and 345 nm, 7,8 due to the widespread applications of laser corneal refractive surgery. With the increasing use of infrared lasers in diverse fields, including military, medicine, and industry, concerns have been raised about the potential injuries of infrared lasers.…”

Section: Introductionmentioning

confidence: 99%

Corneal wound healing following infrared laser irradiation at the wavelengths of 1.319 and 10.6 μm

Zhou,

Yin,

Wang

et al. 2023

Lasers Surg Med

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ObjectivesTo investigate the wound healing of rabbit cornea following infrared laser irradiations at the wavelengths of 1.319 and 10.6 μm.Materials and MethodsTwelve New Zealand rabbits were selected to establish a corneal injury model. The right and left eyes were irradiated with a neodymium‐doped yttrium aluminum garnet laser at the wavelength of 1.319 μm (140 J/cm2) for 0.7 s and a CO2 laser at the wavelength of 10.6 μm (5.94 J/cm2) for 0.14 s, respectively. The incident spot diameter was 3 mm. Optical coherence tomography (OCT) was used to monitor injuries at 0 h, 0.5 h, 1 h, 3 h, 6 h, 12 h, 18 h, 24 h, 30 h, 36 h, 42 h, 48 h, 54 h, 60 h, 66 h, 3 d, 7 d, 14 d, 28 d, 3 m, and 6 m postexposure. Meanwhile, slit‐lamp microscopy and histopathology were performed at 6 h, 24 h, 3 d, 7 d, 14 d, 28 d, 3 m, and 6 m postexposure.ResultsAfter the two types of infrared laser injuries, distinct white circular lesions on the corneal surface were directly observed. Deeper corneal injury, more severe edema, and faster migration of new epithelium were found for the wavelength of 1.319 μm, compared to the wavelength of 10.6 μm.ConclusionsOCT combined with histopathology and slit‐lamp microscopy can clearly observe the dynamic process of corneal wound healing after infrared laser irradiation. The damage characteristics for the two different wavelengths were visibly different, but the whole wound healing process was similar. The obtained results may provide references for the diagnosis, treatment, and evaluation of laser‐induced damages.

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A Comparison of Corneal Cellular Responses After 213-nm Compared With 193-nm Laser Photorefractive Keratectomy in Rabbits

Cited by 4 publications

References 25 publications

Long-Term Followup of LaserIn SituKeratomileusis for Hyperopia Using a 213 nm Wavelength Solid-State Laser

Long-Term Followup of LaserIn SituKeratomileusis for Hyperopia Using a 213 nm Wavelength Solid-State Laser

Photorefractive Keratectomy with Adjunctive Mitomycin C for Residual Error after Laser-Assisted In Situ Keratomileusis Using the Pulzar 213 nm Solid-State Laser: Early Results

Corneal wound healing following infrared laser irradiation at the wavelengths of 1.319 and 10.6 μm

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