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Innovative Technologies in Experimental Corneal Surgery <i>ex vivo</i>

Innovative Technologies in Experimental Corneal Surgery ex vivo

Komarova O.Yu., Lapshin K.E., Burdel K.V., Shatskikh A.V., Zimina M.V., Pashtaev A.N., Novikov S.V., Vartapetov S.K., Izmailova S.B.
Key words: keratoplasty; intrastromal ring; kerato-pigmentation; keratoconus; femtolaser keratotomy; ultrathin graft; femtosecond laser.
2018, volume 10, issue 4, page 84.

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The aim of the study was to assess the feasibility and outcomes of surgical interventions on the cornea in ex vivo experiments using the Femto Visum femtosecond laser system (Optosystems Ltd., Russia).

Materials and Methods. This collective study was conducted by the S. Fyodorov Eye Microsurgery Federal State Institution together with the Scientific-Experimental Production “Eye Microsurgery” Ltd. We have developed a technology for surgical intervention on the cornea with the polymeric intrastromal ring implantation aimed to prevent post-keratoplastic astigmatism. To correct defects of the iris, an original colored gel implant was inserted into the corneal tunnel. With the participation of Optosystems Ltd., we developed an algorithm and related software for using femtolaser keratotomy in the treatment of progressive keratoconus. These interventions were performed with 23 donor (cadaver) eyes that had been earlier rejected for a possible use in human keratoplasty. To assess the feasibility of the posterior lamellar keratoplasty using Femto Visum, we tested the surface quality of the ultrathin grafts prepared from 10 isolated corneal flaps.

Results. The proposed keratoplasty technology and the implantation of the intrastromal ring resulted in a complete corneal penetration free from adverse tissue bridges or adhesions. Following the kerato-pigmentation procedure, the gel-colored implant was found stably held in the preformed corneal tunnel; the remaining cornea areas remained intact. The femtolaser-assisted keratotomy resulted in radial incisions at the pre-determined locations. According to the roughness parameter, the surface quality of the ultrathin grafts produced with the femtosecond laser assistance was similar to that of the standard samples produced with a mechanical microkeratome.

Conclusion. The use of the Femto Visum femtosecond laser system in innovative areas of corneal surgery is effective and safe.


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