Purchase this article with an account.
Bennie H. Jeng, William Gilmer; Laboratory Model of Bursting Pressures of Femtosecond Laser-assisted Keratoplasty Wounds Using Novel Pattern Designs. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3381.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Most current femtosecond laser-assisted keratoplasty wound shapes have either the anterior or the posterior diameter larger than the other. In the case of a larger anterior diameter, there can be a higher risk of graft vascularization, and in the case of a larger posterior diameter, there can be a higher risk of angle closure and subsequent glaucoma. The purpose of this study was to investigate the wound leakage pressure of 2 novel pattern designs for femtosecond laser-assisted keratoplasty, each of which allows for the creation of a cut with the same anterior and posterior wound diameters.
Full-thickness cuts were made in 14 corneoscleral rims with the femtosecond laser using 2 novel pattern designs and 1 established design. Both novel patterns, the "bolt" (n=5) and the "dove-tail" (n=4), were designed to have 8 mm anterior and posterior wound diameters. The established pattern, the "top-hat" (n=5), was cut with 7 mm anterior and 9 mm posterior wound diameters. In addition, 8 mm vertical cuts were created in 5 other corneoscleral rims. All buttons were replaced and sutured with 16 interrupted 10-0 nylon sutures, and the wound leakage pressures were measured using a digital manometer.
The average wound leakage pressure of the "bolt" was 84.6 mmHg; of the "dove-tail" was 106.5 mmHg; of the "top-hat" was 92.4 mmHg; and of the vertical cut was 38.2 mmHg. There was a statistically significant difference between all of the shaped cuts compared to the vertical cut (p<0.001), but there was no difference between the "top-hat" and the novel shapes (p=0.15).
Both novel patterns demonstrated similar resistance to wound leakage compared to the established design, and they offer the advantage of having the same size anterior and posterior wound diameters.
This PDF is available to Subscribers Only