Kermani O, Oberheide U, Will G F, Massow O, Lubatschowski H
Augenklinik am Neumarkt, Köln.
Klin Monbl Augenheilkd. 2009 Dec;226(12):965-9. doi: 10.1055/s-0028-1109682. Epub 2009 Dec 15.
In LASIK (laser in situ keratomileusis) the thickness of the corneal flap is important since it is the residual corneal bed that determines corneal stability. The introduction of real-time OCT visualisation of the corneal layers during the fs-laser cut should enable the surgeon to control and monitor the position of the plane of laser-tissue-interaction during operation. To prove that optical coherence tomography (OCT) can be useful to guide femtosecond (fs)-laser in Sub-Bowman-Keratomileusis (SBK) an in-vitro experimental study was performed on human autopsy eyes in a research laboratory set-up.
Five human autopsy eyes, unsuitable for transplantation, received fs-laser keratomileusis (flap) cuts. The laser procedure was controlled in real-time with an OCT system (Thorlabs HL AG, Lübeck, Germany) to ensure that the cut was placed just underneath Bowman's layer. As a control all eyes were dissected histologically (H & E staining) and examined under the light microscope (LM).
Videomonitoring of the laser process supported the feasibility of the concept to online monitor the fs-laser cutting process via OCT. A clear distinction of the corneal epithelium was possible in all eyes. Bowman's membrane was not identified in all autopsy eyes at the given resolution of the OCT used in this study. Still, LM sections confirmed that the online monitoring assured a positioning of the cutting plane at minimum distance underneath Bowman's membrane.
It was proven that real-time OCT monitoring of fs-laser SBK on human eyes is in principle possible.
在准分子原位角膜磨镶术（LASIK）中，角膜瓣的厚度很重要，因为决定角膜稳定性的是剩余的角膜基质床。在飞秒激光切割过程中引入角膜各层的实时光学相干断层扫描（OCT）可视化技术，应能使外科医生在手术过程中控制和监测激光与组织相互作用平面的位置。为了证明光学相干断层扫描（OCT）可用于引导准分子下基质角膜磨镶术（SBK）中的飞秒（fs）激光，在一个研究实验室环境中，对人类尸眼进行了一项体外实验研究。
五只不适用于移植的人类尸眼接受了飞秒激光角膜磨镶术（制作角膜瓣）切割。使用OCT系统（德国吕贝克的Thorlabs HL AG公司）对激光手术进行实时控制，以确保切割刚好位于Bowman层下方。作为对照，对所有眼睛进行组织学解剖（苏木精和伊红染色）并在光学显微镜（LM）下检查。
激光过程的视频监测支持了通过OCT在线监测飞秒激光切割过程这一概念的可行性。在所有眼睛中都能清晰区分角膜上皮。在本研究使用的OCT给定分辨率下，并非所有尸眼中都能识别出Bowman膜。尽管如此，LM切片证实在线监测确保了切割平面位于Bowman膜下方的最小距离处。
已证明对人眼进行飞秒激光SBK的实时OCT监测原则上是可行的。
