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Morphology, Accuracy, and Histology of Corneal Flap Cuts Using a 200 kHz Femtosecond Laser. R. Khoramnia C.P. Lohmann J. Salgado C. Winkler von Mohrenfels. ASCRS 2010. Augenklinik, Klinikum rechts der Isar, Technische Universität München , Munich, Germany - PowerPoint PPT Presentation
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Klinik und Poliklinik für Augenheilkunde
Morphology, Accuracy, and Histology of Corneal Flap Cuts Using a
200 kHz Femtosecond Laser
Augenklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
All authors have no financial interest in the subject matter of this poster.
The laser system used is not FDA approved and does not yet have a CE mark.
ASCRS 2010
R. Khoramnia C.P. Lohmann
J. Salgado C. Winkler von Mohrenfels
Klinik und Poliklinik für Augenheilkunde
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Purpose
- LASIK requires precise corneal flap cutting.
- Especially the creation of thin flaps has recently gained importance for
Sub-Bowman keratomileusis (SBK), which requires precise cutting.
- There is a tendency towards faster femtosecond lasers that produce
flaps more quickly.
We analyzed flaps created with a prototype 200
kHz femtosecond laser (UltraFlap; WaveLight AG,
Erlangen, Germany) concerning their cut
accuracy, morphology, and histology.
Klinik und Poliklinik für Augenheilkunde
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Material and methodsPreparation
36 fresh porcine eyes: Epithelial abrasion
Surgery
Femtosecond laser flap cutting using the 200 kHz femtosecond laser
-> Three thickness groups (100 µm, 130 µm, or 180 µm)
-> Flap diameters were varied ranging from 8.0 to 9.5 mm
Examination
1.) Flap diameters were measured with a sliding caliper.
2.) Flap thickness was measured with a micrometer gauge (Extramess 2000; Mahr, Esslingen, Germany). Accuracy of this device: 0.3 µm
3.) Histologic examination
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Results: Flap thickness
Accuracy - Statistical analysis:
Significant difference between the 130- and 180-μm group (Mann-Whitney-U test; p < 0.05)
All other comparisons: No significant differences (Mann-Whitney-U test; p > 0.05).
Box-and-whisker plot
Mean values: 96.33±7.45 134.67±4.96 174.59±9.35 [µm]
Klinik und Poliklinik für Augenheilkunde
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Results: Flap diameter
Accuracy - Statistical analysis:
The deviation between measured and attempted diameters was not significantly different between the four diameters (Kruskal-Wallis test; p > 0.05).
Box-and-whisker plot
Mean values: 8.03±0.15 8.03±0.15 9.09±0.10 9.54±0.15 mm [mm]
Klinik und Poliklinik für Augenheilkunde
Results: Histological examination
Histology showed a smooth cut with very little to almost no changes in the corneal structure.
(A) A 180-µm flap in the region of the side cut.
(B) Stromal bed in the region of the side cut (flap thickness: 100 µm).
(C) A 130-µm flap and the stromal bed.
H&E staining; original
magnification, x20.
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Conclusions
- Flap creation was performed easily without any complications.
- Morphology and accuracy of the cuts were very reliable and precise.
- Histology showed a smooth cut with very little to almost no changes in the corneal structure.
-> Therefore, the 200 kHz femtosecond laser seems to be a promising new device in refractive surgery.
Klinik und Poliklinik für Augenheilkunde
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CONTACT
Klinik und Poliklinik für Augenheilkunde
Klinik und Poliklinik für Augenheilkundeam Klinikum rechts der Isar
Ismaninger Str. 2281675 MunichGERMANY
SECRETARIATTel. + 49 89 41 40-23 20Fax + 49 89 41 40-48 58
E-Mail: [email protected]: www.augenklinik-mri.de