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体外猪角膜和巩膜组织的近红外激光组织焊接

NIR laser tissue welding of in vitro porcine cornea and sclera tissue.

作者信息

Savage Howard E, Halder Rabindra K, Kartazayeu Uladzimir, Rosen Richard B, Gayen Tapan, McCormick Steven A, Patel Neil S, Katz Alvin, Perry Henry D, Paul Misu, Alfano R R

机构信息

Department of Pathology, New York Eye and Ear Infirmary, 2nd Avenue & 14th Street, New York, NY 10003, USA.

出版信息

Lasers Surg Med. 2004;35(4):293-303. doi: 10.1002/lsm.20094.

Abstract

BACKGROUND AND OBJECTIVE

The objective of this study was to test the hypothesis that an near infrared (NIR) laser system (1,455 nm) in combination with a motorized translational stage to control the position and speed of the laser beam and a shutter to control the laser exposure to the tissue being welded could be used to successfully weld ocular tissues.

STUDY DESIGN/MATERIALS AND METHODS: Seventy-five porcine corneas and 23 porcine scleral tissues were welded in vitro in this study. The welded tissues were examined using histopathology and tensile strength analysis. Eight different welding conditions were analyzed for porcine cornea and one for sclera tissues. The tensile strength of the welded groups was compared to a sutured cornea control group.

RESULTS

The NIR laser welding system provides strong, full thickness welds and does not require the use of extrinsic dyes, chromophores, or solders. Mean weld strengths of 0.15-0.45 kg/cm(2) were obtained for the cornea and 1.01 kg/cm(2) for sclera welds. The native H(2)O in the ocular tissue serves as an absorber of the 1,455 nm radiation and helps to induce the welds.

CONCLUSIONS

We conclude that an NIR laser system using an optimal laser radiation wavelength of 1,455 nm can effectively weld cornea and sclera tissue and that this laser tissue welding (LTW) methodology typically causes minimal disruption of tissue, and thus, avoids opacities and irregularities in the tissue which may result in decreased visual acuity. The optimization of a laser welding system that leads to a strong full thickness tissue bond without tissue destruction, an instant seal that promotes wound healing, and the absence of a continued presence of a foreign substance like a suture, is of considerable importance to the ophthalmology medical community. This need is especially apparent with respect to corneal transplantation and fixing the position of corneal flaps in Laser-Assisted In Situ Keratomileusis (LASIK), a laser procedure used to permanently change the shape of the cornea.

摘要

背景与目的

本研究的目的是验证以下假设:结合电动平移台以控制激光束的位置和速度以及快门以控制激光对焊接组织的照射的近红外(NIR)激光系统(1455纳米)可成功用于焊接眼部组织。

研究设计/材料与方法:本研究对75个猪角膜和23个猪巩膜组织进行了体外焊接。使用组织病理学和拉伸强度分析对焊接组织进行检查。对猪角膜分析了8种不同的焊接条件,对巩膜组织分析了1种焊接条件。将焊接组的拉伸强度与缝合角膜对照组进行比较。

结果

近红外激光焊接系统可提供牢固的全层焊接,且无需使用外部染料、发色团或焊料。角膜焊接的平均强度为0.15 - 0.45千克/平方厘米,巩膜焊接的平均强度为1.01千克/平方厘米。眼部组织中的天然水作为1455纳米辐射的吸收体,有助于引发焊接。

结论

我们得出结论,使用最佳激光辐射波长1455纳米的近红外激光系统可有效焊接角膜和巩膜组织,并且这种激光组织焊接(LTW)方法通常对组织的破坏最小,因此可避免可能导致视力下降的组织混浊和不规则。优化激光焊接系统以实现牢固的全层组织结合而不破坏组织、促进伤口愈合的即时密封以及不存在像缝线这样的异物持续存在,对眼科医学界具有相当重要的意义。在角膜移植以及在准分子原位角膜磨镶术(LASIK,一种用于永久改变角膜形状的激光手术)中固定角膜瓣的位置方面,这种需求尤为明显。

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