Planar Lamellar Refractive Keratoplasty

Swinger, Casimir A.; Krumeich, J. H.; Cassiday, Daniel

doi:10.3928/1081-597x-19860101-05

Cited by 47 publications

(5 citation statements)

References 11 publications

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“…Instead of freezing the resectioned cornea, the corneal cap was placed on a suction mould based on the attempted refractive correction for the microkeratome to make the refractive cut. Unfortunately, it too was unsuccessful at correcting astigmatism but on the plus side, it was associated with fewer complications than freeze techniques …”

Section: Keratomileusismentioning

confidence: 99%

Corneal refractive surgery: past to present

McAlinden

2012

Clinical and Experimental Optometry

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There have been many historical corneal refractive techniques and procedures developed over the years. From early techniques of radial keratotomy to modern excimer laser techniques, the field of refractive surgery is one of the most rapidly developing in ophthalmology. This review details the historical aspects of the many early techniques up to current techniques used on millions of eyes around the world.

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Section: Keratomileusismentioning

confidence: 99%

Corneal refractive surgery: past to present

McAlinden

2012

Clinical and Experimental Optometry

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“…10,11 This BKS non-freeze technique involved placing the ressected disc epithelial side down onto a curved suction die or mold where a second pass of the microkeratome removed tissue from the exposed posterior stromal surface according to the shape of the die (Fig 6). 10,11 This BKS non-freeze technique involved placing the ressected disc epithelial side down onto a curved suction die or mold where a second pass of the microkeratome removed tissue from the exposed posterior stromal surface according to the shape of the die (Fig 6).…”

Section: Barraquer-krumeich-swinger Techniquementioning

confidence: 99%

The History of LASIK

Reinstein¹,

Archer²,

Gobbé³

2012

J Refract Surg

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Keratomileusis, brainchild of Jose I. Barraquer Moner, was conceived and developed as the first stromal sculpting method to correct refractive error in 1948. The word "keratomileusis" literally means "sculpting" of the "cornea." Barraquer's first procedures involved freezing a disc of anterior corneal tissue before removing stromal tissue with a lathe. Over the years, the procedure continued to develop, first through the Barraquer-Krumeich-Swinger non-freeze technique where tissue was removed from the underside of the disc by a second pass of the microkeratome. In-situ keratomileusis was later developed by passing the microkeratome a second time directly on the stromal bed. The procedure became known as automated lamellar keratoplasty with the invention of an automated microkeratome and was further refined by replacing the disc without sutures and later by stopping the microkeratome before the end of the pass to create a hinged flap, as first demonstrated in 1989. The history of the excimer laser dates back to 1900 and the quantum theory, eventually leading to the discovery that 193-nm ultraviolet excimer laser pulses could photoablate tissue without thermal damage. Ultrastructural and wound healing studies confirmed that large area ablation could be performed in the central cornea. This was described as photorefractive keratectomy in 1986 and the first sighted eyes were treated in 1988. An excimer laser was first used to sculpt from the stromal bed under a hinged flap created manually using a trephine and scalpel in 1988. The incorporation of a microkeratome in 1990 finally led to laser in situ keratomileusis-LASIK-as we know it today.

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“…Keratomileusis in situ (Figure 6) consists of removing two concentric, lamellar disks from the anterior cornea, the second underlying resection being smaller in diameter than the first. [34][35][36][37] The devices that remove these lamellar tissues are known as microkeratomes. The first disk contains the epithelium, Bowman's membrane, and some anterior stroma, and is left attached to the stroma by a hinge as discussed earlier.…”

Section: Keratomileusis In Situmentioning

confidence: 99%

“…Similarly, it may be shown that a 10-D corrective cut at 5.5 mm will have an insert radius of 37.6 mm, a central tissue thickness of 100.70 m, a 5.4-mm optical zone, and a resultant power reduction of 9.7 D. It may be analytically shown that the preoperative anterior corneal radius R O does not significantly affect the insert radius R I required to correct for a known refractive error. 4,34,43 Therefore the optical inserts only need to be specified in terms of optical power and not as a function of preoperative corneal radius.…”

Section: Optical Verificationmentioning

confidence: 99%

New method for reshaping the cornea

Littlefield¹,

Koepnick

Binder³

et al. 1997

J. Biomed. Opt.

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The optical theory behind a new technique for reshaping the cornea to correct refractive errors of the eye is presented. This technique is capable of excising both positive and negative meniscus (lenticular)-shaped tissues of predetermined optical power from the anterior cornea. The optical lens bending theory routinely used by optical designers to reduce the amount of spherical and comatic aberrations in a lens system is employed in this technique. This technique uses a microkeratome to remove a planoconvex, or planoconcaveshaped tissue from the cornea while the eye is in a deformed state. When the eye returns to its natural, undeformed state, a lenticular tissue of predetermined optical power has been removed, correcting for myopic or hyperopic refractive errors, respectively. An elementary introduction to the current surgical techniques used for the correction of refractive errors is presented. Meniscus cross sections of the excised tissues are shown to demonstrate the optical theory discussed.

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Planar Lamellar Refractive Keratoplasty

Cited by 47 publications

References 11 publications

Corneal refractive surgery: past to present

Corneal refractive surgery: past to present

The History of LASIK

New method for reshaping the cornea

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