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James E Hill, Alireza Malek Tabrizi, Hong Fu, Ling C. Huang, Ronika S Leang; Assessment of Next Generation Femtosecond Laser Using Scanning Electron Microscopy and Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4882.
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© ARVO (1962-2015); The Authors (2016-present)
We present preliminary results for a novel femtosecond (FS) laser for creating corneal flaps on porcine globes.
The novel next generation FS Laser was used to create LASIK flaps in porcine eyes (N=28) with a smaller laser spot size, faster rep rate and lower energy than current state of the art FS laser systems. Gross assessment of the laser pattern and placement were viewed with a surgical grade microscope. The lift of the flap was assessed using a scale of 1-4 (1= no lift, 2= moderate, 3= minimal, 4= no adhesion). Optical Coherence Tomography (OCT) was used to evaluate wound architecture for uniform pattern fidelity. The flaps were removed and the cornea resected was sent for Scanning Electron Microscopy (SEM) analysis to evaluate the bed quality.
Following laser treatment, the globes were examined under a surgical grade microscope. A complete pattern was discernible with lighter and darker bubble patterns dependent upon the laser energy used. Uniformity of the bubble patterns can lead to a better lift of the flap as well as a smoother bed as noted by Aristeidou et al (2015 Eye and Vision). The novel next generation laser had uniform bubble patterns with no adhesions of the bed or entry side cut lift using a single uniform swipe with spatula from superior hinge to inferior edge of the flap. With 15 eyes = 4, 5 eyes = 4-, and 8 eyes = 3+. The bed quality after the lift appeared even and smooth as viewed through the microscope at 100X. The OCT images presented even spacing for flap location and depth. The SEM images of the bed tissue were smooth with no noticeable unevenness even at high magnification (250X).
Evaluation of the bubble pattern showed consistent pattern fidelity which was verified by uniform OCT images showing well demarcated lines of uniform depth. The SEM images compared to current state of the art FS laser system demonstrated very similar quality with smooth beds at high magnification. The flap lifts created by this novel next generation FS laser are equivalent or better for performing LASIK surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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