Laser-Assisted Penetrating Keratoplasty: 1-Year Results in Patients Using a Laser-Welded Anvil-Profiled Graft

Canovetti, Annalisa; Malandrini, Alex; Lenzetti, Ivo; Rossi, Francesca; Pini, Roberto; Menabuoni, Luca

doi:10.1016/j.ajo.2014.07.010

Cited by 22 publications

(7 citation statements)

References 32 publications

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“…In laser-welding, a spot on the approximated edges of an incision is heated by laser light absorption in the tissue or in a coloring agent (which changes the penetration depth of the light). [8][9][10] The spot is heated to temperature T for time t, causing adhesion. The full length of the incision is then bonded, spot by spot.…”

Section: Introductionmentioning

confidence: 99%

Strong bonding of corneal incisions using a noncontact fiber-optic laser soldering method

et al. 2019

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Suturing of corneal incisions requires significant skill. We demonstrate a noncontact method that will simplify the bonding process. 5-mm-long penetrating vertical and slanted incisions were made in corneas of eyes, extracted from dead piglets. A fiber-optic laser system was used for laser soldering of the incisions, under close temperature control, using albumin solder. The burst-pressure P B immediately after the soldering was found to be P B ≈ 92 and 875 mmHg, for vertical and slanted incisions, respectively. P B ¼ 875 mmHg is an exceptionally high figure, ≈10 times the clinically acceptable value for sutured incisions. Laser soldering was then performed on penetrating incisions made in the corneas of live healthy piglets, of weight ≈10 Kg. After a healing period, the eyes were extracted, and the corneas were examined by histopathology and by optical coherence tomography. Our method immediately generated watertight and strong bonding without noticeable corneal shape distortion. These results would be beneficial for cataract surgery and for corneal transplantations. The fiber-optic system makes it much easier to bond corneal incisions. In the future, laser soldering could be automated and efficiently used by less experienced surgeons, thereby reducing the workload on the experienced ones.

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Section: Introductionmentioning

confidence: 99%

Strong bonding of corneal incisions using a noncontact fiber-optic laser soldering method

et al. 2019

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“…The temperature enhancement induces reversible thermal denaturation in the stromal collagen, with an immediate closuring of the wound walls upon cooling. This laser welding effect was firstly demonstrated in cataract surgery 7,8 and penetrating keratoplasty 9,10 . An optimized approach that we are presenting in this paper has been studied for application in endothelial keratoplasty.…”

Section: Introductionmentioning

confidence: 94%

An “All-laser” Endothelial Transplant

Rossi

Canovetti

Malandrini

et al. 2015

JoVE

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The "all laser" assisted endothelial keratoplasty is a procedure that is performed with a femtosecond laser used to cut the donor tissue at an intended depth, and a near infrared diode laser to weld the corneal tissue. The proposed technique enables to reach the three main goals in endothelial keratoplasty: a precise control in the thickness of the donor tissue; its easy insertion in the recipient bed and a reduced risk of donor lenticule dislocation. The donor cornea thickness is measured in the surgery room with optical coherence tomography (OCT), in order to correctly design the donor tissue dimensions. A femtosecond laser is used to cut the donor cornea. The recipient eye is prepared by manual stripping of the descemetic membrane. The donor endothelium is inserted into a Busin-injector, the peripheral inner side is stained with a proper chromophore (a water solution of Indocyanine Green) and then it is pulled in the anterior chamber. The transplanted tissue is placed in the final and correct location and then diode laser welding is induced from outside the eyeball. The procedure has been performed on more than 15 patients evidencing an improvement in surgery performances, with a good recovery of visual acuity and a reduced donor lenticule dislocation event. Video LinkThe video component of this article can be found at

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“…In particular, we bound KerAzAPDred films to porcine corneas, which represents a convenient model with a history of preclinical trials in laser welding and soldering. [47][48][49][50] Single spot irradiation with ms-long optical pulses through a fiber-optic delivery system triggered melting of the corneal tissue and KerAzAPDred films. The tensile strength was tested by using surgical tweezers and survived a load in excess of several load factor (g), in line with that found with capsular tissue or chitosan hydrogels doped with indocyanine green [51,52] or plasmonic particles [34,53] and sufficient to withstand subsequent manipulation with surgical tools for the preparation of histological sections.…”

Section: Near Ir Laser Solderingmentioning

confidence: 99%

Mild and Effective Polymerization of Dopamine on Keratin Films for Innovative Photoactivable and Biocompatible Coated Materials

Posati

Ferroni

Aluigi

et al. 2018

Macro Materials & Eng

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Mussel‐inspired polydopamine (PD) coating represents a promising route for constructing functional materials and finely tuning or completely changing their surface properties. In this work, a mild and effective method to realize the deposition of PD on keratin‐based films is reported. Reactive oxygen species (ROS), generated by keratin films doped with a photosensitizer, e.g., Azure A (AzA), upon UV–vis and vis‐near IR irradiation, are exploited to obtain the PD coating. Interestingly, the use of vis‐near IR irradiation leads to an increased production of ROS by AzA resulting in a greater PD deposition. Compared to uncoated keratin films, the PD‐keratin coated materials show a granular but homogeneous surface and an increased hydrophilicity, maintaining the ROS generation ability of AzA. This work demonstrates a useful method to effectively and rapidly functionalize with PD materials that are sensitive to temperature, pH and UV light, such as keratin. The proposed strategy allows obtaining new multifunctional biomaterials of potential interest in tissue engineering and drug delivery; in particular, the use of PD‐keratin films for near IR laser bonding of ophthalmic tissue, which is a representative case in wound healing purpose, is shown.

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Laser-Assisted Penetrating Keratoplasty: 1-Year Results in Patients Using a Laser-Welded Anvil-Profiled Graft

Cited by 22 publications

References 32 publications

Strong bonding of corneal incisions using a noncontact fiber-optic laser soldering method

Strong bonding of corneal incisions using a noncontact fiber-optic laser soldering method

An “All-laser” Endothelial Transplant

Mild and Effective Polymerization of Dopamine on Keratin Films for Innovative Photoactivable and Biocompatible Coated Materials

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Laser-Assisted Penetrating Keratoplasty: 1-Year Results in Patients Using a Laser-Welded Anvil-Profiled Graft

Cited by 22 publications

References 32 publications

Strong bonding of corneal incisions using a noncontact fiber-optic laser soldering method

Strong bonding of corneal incisions using a noncontact fiber-optic laser soldering method

An &#8220;All-laser&#8221; Endothelial Transplant

Mild and Effective Polymerization of Dopamine on Keratin Films for Innovative Photoactivable and Biocompatible Coated Materials

Contact Info

Product

Resources

About

An “All-laser” Endothelial Transplant