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J. B. Malta, M. Banitt, H. Soong, R. Shtein, D. Musch, A. Sugar, S. Mian; Femtosecond Laser-Assisted Keratoplasty: Wound Shapes, Surgical Technique and Image Analysis in Eye Bank Globes. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1959.
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To optimize the surgical technique for performing femtosecond laser-assisted keratoplasty (FLAK) using the Intralase FS to cut both recipient and donor cornea buttons in eye bank globes.
Thirty eye bank globes and 30 corneoscleral buttons were used to perform FLAK in 6 globes and 6 corneoscleral buttons measured for each of the following trephination patterns: top hat, mushroom, zigzag and vertical cuts. In addition, mechanical trephination was performed in 6 globes and 6 corneoscleral buttons. The integrity of the incisions was tested with 8 sutures, 8 sutures with fibrin glue and 16 sutures by measuring the intraocular pressure required to produce graft-host wound leakage and dehiscence (IOPL). Light microscopic histology and scanning electron microscopy were performed to assess surface quality and graft-host interface regularity.
Mushroom patterned FLAK had higher IOPL than mechanical trephination, vertical and zigzag pattern for suture technique (p<0.05). There was no difference in IOPL with mushroom, top hat and zigzag patterns when comparing 8 sutures plus fibrin glue to 16 suture wound closure technique (p>0.05). Light microscopic histology and scanning electron microscopy demonstrated that the cut surfaces were of very good quality with straight and orthogonal edges with minimal collateral laser damage.
Patterns FLAK may be provide grader wound stability than mechanical trephination and vertical pattern FLAK.
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