Tal Kfir, Strassmann Eyal, Loya Nino, Ravid Avi, Kariv Noam, Weinberger Dov, Katzir Abraham, Gaton Dan D
Department of Ophthalmology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, 49100, Israel,
Lasers Med Sci. 2015 May;30(4):1367-71. doi: 10.1007/s10103-015-1737-2. Epub 2015 Mar 22.
We aimed to evaluate the effectiveness of temperature-controlled laser soldering for repair of large perforated corneas in a porcine model. Eight Yorkshire pigs aged 6 months underwent 6-mm-deep 180° crescent-shaped trephination of the central corneas. Right corneal injuries were repaired by placement of 47 % bovine albumin along the cut followed by CO2 laser soldering (power density 16 W/cm(2)) to a target temperature of 65(°). Left corneal injuries were repaired with 10/0 nylon sutures. The groups were compared for operative time, leakage, and histopathological findings. Mean tissue temperature was 63 ± 4 °C. Mean operative time was 31.57 ± 2.8 min in laser-soldered eyes and 41.38 ± 2.3 min in controls (p < 0.0001, unpaired Student's t test). Compared to controls, the soldered corneas had less neovascularization, complete re-epithelization, and mild stromal inflammation. There was no leakage in either group. Combined CO2 laser and radiometer is effective for the in vivo repair of corneal cuts. These results have important implications for modern corneal surgery. Further studies are needed in the clinical setting.
我们旨在评估在猪模型中，温控激光焊接修复大的角膜穿孔的有效性。八只6月龄的约克夏猪接受了中央角膜6毫米深、180°新月形的环钻术。右眼角膜损伤通过沿切口放置47%的牛白蛋白，随后用二氧化碳激光焊接（功率密度16 W/cm²）至目标温度65°C进行修复。左眼角膜损伤用10/0尼龙缝线修复。比较两组的手术时间、渗漏情况和组织病理学结果。平均组织温度为63±4°C。激光焊接组的平均手术时间为31.57±2.8分钟，对照组为41.38±2.3分钟（p<0.0001，非配对学生t检验）。与对照组相比，焊接后的角膜新生血管较少，上皮完全再生，基质炎症较轻。两组均无渗漏。二氧化碳激光和辐射计联合使用对角膜切口的体内修复有效。这些结果对现代角膜手术具有重要意义。临床环境中还需要进一步研究。
