Parker Jack S, Huls Forest, Cooper Elizabeth, Graves Paul, Groeneveld-van Beek Esther A, Lie Jessica, Melles Gerrit R J
Netherlands Institute for Innovative Ocular Surgery, Rotterdam - The Netherlands.
Melles Cornea Clinic Rotterdam, Rotterdam - The Netherlands.
Eur J Ophthalmol. 2017 Nov 8;27(6):675-677. doi: 10.5301/ejo.5000990. Epub 2017 May 26.
To evaluate the technical feasibility of isolated Bowman layer (BL) graft preparation by femtosecond laser (FSL) and to compare the ultrastructural morphology to manually dissected grafts.
Five whole globes were placed in custom-made eye holders and debrided of epithelium. After programming a dissection depth of 20 μm, the FSL was docked into position and 5 isolated BL grafts were created. From 5 additional globes, corneoscleral buttons were procured, mounted in artificial anterior chambers, and stripped of BL via the previously described manual technique. Three specimens from both series were randomly selected and assigned to transmission electron microscopy for ultrastructural evaluation and thickness measurements.
All dissections were uneventful and 10 total grafts were produced: 5 by FSL and 5 by manual dissection. Mean graft thickness was 37 (±8.6) μm (n = 3) for the FSL group and 11.7 (±1.6) μm (n = 3) for the manually dissected group. Transmission electron microscopy revealed a thick but relatively smooth posterior cut edge in the FSL group, versus a virtually isolated BL with irregular rests of dispersed stroma in the manually dissected group.
Femtosecond laser may have potential for harvesting intact BL and with a smooth posterior surface, but accompanied by variable amounts of anterior stroma owing to technical limitations.
评估飞秒激光（FSL）制备孤立Bowman层（BL）移植物的技术可行性，并将其超微结构形态与手动剖切的移植物进行比较。
将5个完整眼球置于定制的眼托中并去除上皮。设定剖切深度为20μm后，将飞秒激光定位并制作5个孤立的Bowman层移植物。从另外5个眼球获取角膜巩膜纽扣组织，安装在人工前房中，并通过上述手动技术剥离Bowman层。从两个系列中随机选取3个标本，用于透射电子显微镜检查以进行超微结构评估和厚度测量。
所有剖切均顺利进行，共制作了10个移植物：5个通过飞秒激光制作，5个通过手动剖切制作。飞秒激光组移植物平均厚度为37（±8.6）μm（n = 3），手动剖切组为11.7（±1.6）μm（n = 3）。透射电子显微镜显示，飞秒激光组后剖切边缘厚但相对光滑，而手动剖切组为几乎孤立的Bowman层，伴有散在的不规则基质残余。
飞秒激光在获取完整的Bowman层且后表面光滑方面可能具有潜力，但由于技术限制会伴有不同量的前基质。
