Sightline Ophthalmic Associates, Sewickley, PA, USA.
Cornea. 2013 Jan;32(1):81-6. doi: 10.1097/ICO.0b013e31825c72dc.
To evaluate the endothelial cell survival and stromal bed quality when creating deep stromal cuts with a low-pulse energy, high-frequency femtosecond laser to produce "ultrathin" tissue for Descemet stripping automated endothelial keratoplasty.
Seventeen corneas were used for this study. Five corneas were cut with the laser at a depth of 420 to 500 μm to produce a tissue thickness of approximately ≤70 μm. Five corneas served as an uncut comparison group. Vital dye staining and computer digitized planimetry analysis were performed on these corneas. The 7 remaining corneas were cut for scanning electron microscopy evaluation.
The mean central posterior stromal thickness of cut corneas was 60.6 μm (range, 43-72 μm). Endothelial cell damage in cut and comparison corneas was 3.92% ± 2.22% (range, 1.71%-6.51%) and 4.15% ± 2.64% (range, 1.21%-7.01%), respectively (P = 0.887). Low-magnification (×12) scanning electron microscopy revealed a somewhat irregular-appearing surface with concentric rings peripherally. Qualitative grading of higher magnification (×50) central images resulted in an average score of 2.56 (between smooth and rough).
Ultrathin tissue for Descemet stripping automated endothelial keratoplasty can be safely prepared with minimal endothelial cell damage using a low-pulse energy, high-frequency femtosecond laser; however, the resulting stromal surface quality may not be optimal with this technique.
评估使用低能量、高频飞秒激光制作深层基质切口以产生用于 Descemet 剥离自动内皮角膜移植术的“超薄”组织时内皮细胞的存活率和基质床质量。
本研究使用了 17 个角膜。5 个角膜用激光切割至 420 至 500μm 的深度，以产生厚度约≤70μm 的组织。5 个角膜作为未切割的对照组。对这些角膜进行活染料染色和计算机数字化平面分析。剩余的 7 个角膜用于扫描电子显微镜评估。
切割角膜的中央后基质平均厚度为 60.6μm（范围 43-72μm）。切割和对照角膜的内皮细胞损伤分别为 3.92%±2.22%（范围 1.71%-6.51%）和 4.15%±2.64%（范围 1.21%-7.01%）（P=0.887）。低倍（×12）扫描电子显微镜显示出一种表面外观略微不规则，周边有同心环。高倍（×50）中央图像的定性分级平均得分为 2.56（介于光滑和粗糙之间）。
使用低能量、高频飞秒激光可以安全地制备用于 Descemet 剥离自动内皮角膜移植术的超薄组织，同时对内皮细胞的损伤最小；然而，这种技术产生的基质表面质量可能不是最佳的。
