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Louise Mulroy, June Kim, Irene Wu, Philip Scharper, Samir A. Melki, Dimitri T. Azar, Robert W. Redmond, Irene E. Kochevar; Photochemical Keratodesmos for Repair of Lamellar Corneal Incisions. Invest. Ophthalmol. Vis. Sci. 2000;41(11):3335-3340.
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purpose. To determine the efficacy of photochemical keratodesmos (PKD) for
closing surgical incisions in the cornea of enucleated rabbit eyes
compared with that achieved using sutures and self-sealing incisions.
methods. A 3.5-mm incision, at an angle parallel to the iris, was made in the
cornea of enucleated New Zealand White rabbit eyes. The intraocular
pressure required to cause leakage (IOPL) from the
untreated incision was then recorded. Photochemical keratodesmos
treatment was then performed by application of a dye, Rose Bengal (RB),
in saline solution to the surfaces of the incision wound, followed by
laser irradiation at 514 nm from an argon ion laser. Immediately after
treatment, the IOPL was measured. Both dose and laser
irradiance dependencies were studied in five or more eyes for each
condition and appropriate control eyes. The IOPLs were
compared with those obtained using conventional interrupted 10-0 nylon
sutures. Other dyes were tested in a similar fashion.
results. The IOPL of 300 mm Hg was obtained using a fluence of 1270
J/cm2 with an irradiance of 1.27 W/cm2 (laser
exposure time, 16 minutes 40 seconds). No sealing was observed using
dye or light alone where control pressures of approximately 30 mm Hg
were found. At higher dose (1524 J/cm2) and irradiance
(3.82 W/cm2; 6 minutes 35 seconds), PKD was less effective,
which may be attributable to thermal effects. PKD produced
IOPLs similar to those in closure by sutures. Other dyes
such as riboflavin-5-phosphate and N-hydroxy-pyridine
thione also produced efficient bonding after PKD. Nonphotochemically
active dyes did not produce significant increases in the
IOPL at which leakage occurred.
conclusions. The increase in IOPL after PKD treatment, comparable with
that with sutures, in enucleated rabbit eyes demonstrates the
feasibility of this technique ex vivo.
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