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T. O. Wood, J. M. Freeman, J. Gary, Z. A. Carcioglu; A Morphologic Analysis of the Full Thickness Corneal Button Edges Cut by the Femtosecond Laser Versus Trephination. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4702.
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To describe morphologic differences of the edges ("side cuts") of 8 mm, full thickness corneal buttons obtained by the femtosecond laser versus hand-trephination.
Six eye bank cornoscleral buttons were used. All corneoscleral buttons were placed on a Barron artificial chamber (Katena) to make the cuts. Femtosecond laser (IntraLase Corp., Irvine, CA) vertical cuts were performed on three buttons, with an energy of 4.0 mj and 1200µ thickness. Full thickness hand-trephination was performed in three buttons with 8-mm disposable corneal trephines. Twenty-four specimens obtained from the quadrants of the edges of corneal buttons were examined with H&E, PAS and Masson’s trichrome stains and scanning electron microscopy Philips XL 30 ESEM.
The epithelium was intersected throughout in 5/12 laser specimens, but sloughed off in all trephine specimens. No morphologic differences were observed at Bowman layer level. The stromal cut was right angled and regular in 9/12 laser specimens but irregular and oblique in 10/12 trephine specimens. The Descemet membrane was cut flush to the stroma without any separation in all laser specimens but was out of line and coiled in 11/12 trephine specimens. Endothelial cell studies were not performed because the buttons were rejects for transplantation with poor endothelial layers.
More regular morphologic features were observed in Femtosecond laser-cut, full thickness, human corneal buttons at their margins. Femtosecond laser may be the choice of instrument for donor and recipient corneal button cuts in transplantation surgery, particularly from the standpoint of decreasing irregular scarring at stroma and Descemet membrane levels.
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