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J.-M. J. Legeais, B. Amari, M. Savoldelli; Z and Posterior Endothelial Keratoplasty With Femtosecond Laser. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1945.
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Evaluate the feasability and cut quality of corneal trephination in human and donor opaque corneal tissue with femtosecond laser.
Femtosecond laser trephination was done with an Intralase FS 60 Khz. 8 Z keratoplasties on patients with corneal edema and 6 human donor corneas for posterior lamellar keratoplasties were performed at 300, 600 and 800 µm. Energy levels used for the trephination were deliberatly set high 2.58 µJ to ensure complete detachment. For all procedures a second cut were used in the edematous cornea. The excised corneal discs and corneal buttons were analized by Light microscopy and Transmission electron microscopy.
The femtosecond laser produced an effective and smooth dissection through opaque corneas even at deeper settings. Graft transplantation was fairly simple and effective. All the cut edges examined by Light and electron microscopy were lined by a 2-10 nm electron dense layer without any evidence of thermal damage.
Femtosecond technology have some limitation in opaque cornea. "The second cut procedure" is efficient, precise and safe for all trephination with corneal opacities.
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