Mechanical Strength of of the Cornea after Femtosecond Laser Penetrating Keratoplasty NE Knox Cartwright, 1, 2 JR Tyrer, 2 J Marshall 1 1: Ophthalmology,

Slides:

Advertisements

Similar presentations

Femtosecond Laser–Assisted Sutureless Anterior Lamellar Keratoplasty

Advertisements

Farid Karimian M.D. Department of Ophthalmology

Femtosecond Laser-assisted Penetrating Keratoplasty Mohammad Zare MD Professor of Ophthalmology Labbafinejad Medical Center Shaheed beheshti Medical University.

Recent increased marketing efforts have led some consumers to question if a new procedure called ”Intralase LASIK" is somehow a superior option to.

Himanshu Matalia, MD Ashwini Ranganath, MD N Raghu, MD Rohit Shetty, MD Cornea & Refractive Services, Narayana Nethralaya Super Specialty Eye Hospital.

Venting Incisions in DSAEK Patients: Is It an Absolute Necessity?

Description of a novel “Lock-and-key” configuration for femtosecond assisted keratoplasty A Iovieno; V Chowdhury; V Maurino Moorfields Eye Hospital, NHS.

Swept Source Optical Coherence Tomography for Evaluation of Posterior Corneal Changes after Refractive Surgery Dr. Tommy Chung Yan Chan Dr. Vishal Jhanji.

Early Outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty in Pseudophakic Eyes with Anterior Chamber Intraocular Lenses Preeya K. Gupta.

Biosynthetic Collagen Substitute Proves Useful to Stabilize Corneal Wounds in Combat: A Rabbit Model Karin E. Thomas, MD and Joseph F. Pasternak, MD Walter.

Jatin Ashar1 1Mumbai Eye Care, Cornea and LASIK Centre

Intracorneal ring segments followed by collagen cross-linking and PRK for treatment of keratoconus A Iovieno, MD; ME Légaré, MD; DS Rootman, MD Department.

IN THE NAME OF GOD All-in-one Femtosecond Laser Refractive Surgery Sh.Hanjani, M.D Ophthalmologist.

Partnerships for Success: Corneal Transplant in the 21st Century Breakout Session A Presenters: Christopher Blanton, MD Medical Director, Ocular Services,

Variations in corneal biomechanical parameters and central corneal thickness during the menstrual cycle. David Zadok, MD, Yakov Goldich, MD, Yaniv Barkana,

Somasheila I. Murthy, Prashant Garg, Pravin K. Vaddavalli

Dept. of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. Outcome after big-bubble deep anterior lamellar keratoplasty.

Deep Stromal Dissection for Endothelial Keratoplasty Obtained with a Femtosecond Laser and a Microkeratome with Different Head Advancement Speeds. A Scanning.

Clear Corneal Incisions (CCIs) and innovative blade design in C-MICS Dan Calladine - No financial interests Richard Packard – Consultant for Core Surgical.

Prof. A. John Kanellopoulos, MD 1 Long-term Safety and Efficacy of High-Fluence Collagen Crosslinking of the Vehicle Cornea in.

INTACS – PKP Comparison X X 180°-0.75 TransplantIntacs.

"Management of Advanced Keratoconus with Deep Anterior Lamellar Keratoplasty (DALK).” Rohanah A., Thiageswary U. Department of Ophthalmology, Hospital.

Glaucoma and Penetrating Keratoplasty : Incidence, Risk Factors, and Outcomes Sonika Gupta Consultant Ophthalmology Max Eye Care New Delhi, India Author.

Custom Flap Formation: Advantages of Elliptical Flaps for LASIK Patients Custom Flap Formation: Advantages of Elliptical Flaps for LASIK Patients Henry.

Visualization of Epithelial Downgrowth of Inferior Angle, Iris, and Corneal Endothelium With Means of Endolaser Probe Mahmoud A. Khaimi, MD J. Matthew.

Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy Findings in Femtosecond Laser- Assisted Keratoplasty Kurt H. Kelley, MD;

Case Report of Severe Haze After DSAEK

Indications for and Outcomes of Therapeutic Penetrating Keratoplasty Sonika Gupta Consultant Ophthalmology Max Eye Care New Delhi, India Author has no.

Natalie Stanciu, MD Richard M. Awdeh, MD Takeshi Ide, MD Sonia Yoo, MD Bascom Palmer Eye Institute ASCRS 2009: San Francisco.

Femtosecond Laser ‘Second Pass’ for Incomplete LASIK Flaps Due to Suction Loss and Analysis of Flap Morphology 1 Anil Vedula*, Takeshi Ide*, Payman Haft*

Variations in corneal biomechanical parameters and central corneal thickness during the menstrual cycle. Yakov Goldich, MD, David Zadok MD, Yaniv Barkana,

Paecilomyces Fungal Keratitis: Combining Multiple Strategies to Improve the Outcome of Severe, Pesticide-Associated Fungal Keratitis Jonathan Etter, MD,

Impaired Corneal Wound Healing in Patients on Systemic Colchicine Moshe Lazar MD 1, Yossi Yatziv MD 1 The authors have no financial interest in the subject.

E-Poster Price Vision Group & Cornea Research Foundation of America Descemet - Stripping Endothelial Keratoplasty :Survival Outcomes in Eyes with Pre-

Descemet-Stripping Automated Endothelial Keratoplasty Grafts Prepared from Endothelial Side Using a 500 kHz Femtosecond Laser: Six-Month Outcomes Jesper.

A New Technique for Precise, Predictable SBK Surgery Using the B&L Zyoptix XP Microkeratome David R. Shapiro, MD Shapiro Laser Eye Center Ventura, California.

King Saud University College of Medicine

SALK IN REFRACTIVE SURGERY INDUCED CORNEAL OPACITY- A VIABLE OPTION Anita Ganger, Radhika Tandon, Murgesan Vanathi Cornea & Ocular Surface Services, Dr.

FEMTOSECOND LASER-ASSISTED KERATOPLASTY: WOUND INTEGRITY IN EYE BANK EYES João Baptista Malta, MD, H. Kaz Soong, MD, Roni Shtein, MD, Michael Banitt, MHA,

Retrospective Comparison of Flap Complications in LASIK Using Hansatome Mechanical Microkeratome and Femtosecond Laser Majid Moshirfar, MD Jeffrey P Gardiner,

Daniel D. Hayes, MD1; Carolyn Y. Shih, MD1; David C

Effect of an irregular anterior surface on a lamellar femtosecond laser cut Robert E. Fintelmann, MD Michele M. Bloomer, MD Bennie H. Jeng, MD Authors.

Jodhbir S Mehta, Donald Tan The Authors have a financial Interest in the Endoglide patent/royalty.

Corneal Wound: Architecture and Integrity Luis E. Fernández de Castro, M.D. 1 Helga P. Sandoval, M.D., M.S.C.R. 1 Kerry D. Solomon, M.D. 1 1 Magill Research.

Mushroom shaped wound configurized penetrating keratoplasty and its customized modifications Hong Kyun Kim 1, Sang Hee Lee 2, Won Mun Seo 1. Sun Hwa Chai.

P324: Femtosecond-Assisted DSAEK with Fibrin Glue-Assisted Sutureless Posterior Chamber Lens Implantation Gaurav Prakash, MD Amar Agarwal, MS, FRCS, FRCOphth;

Comparing Factors Affecting Surgically Induced Astigmatism

The authors have no conflicting interest in the subject matter of this poster. In Vivo Evaluation of DSAEK Interface with Scanning- Laser Confocal Microscopy.

Descemet’s Stripping Endothelial Keratoplasty (DSEK) in patients with prior Trabeculectomy or Tube shunt surgery. Thadani S.M. Fynn-Thompson N. Authors.

Case report No financial interest The features of the Femtosecond Laser system flap creation process on the eye after radial keratotomy O.F. Ziiatdinova,

0 Case Study Learning Curve. ACADEMY OF OPHTHALMOLOGY Financial Disclosure The speaker has no financial interest in the subject matter.

Femtosecond laser assisted penetrating keratoplasty

Preoperative Characteristics

Nienke Visser, Tos T.J.M. Berendschot, Rudy M.M.A. Nuijts

Kyoto Prefectural University of Medicine

Customized Corneal Femtosecond Laser Procedures Using

Early Experience with Descemet’s Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification: Clinical and Refractive Outcome University.

Eric Dai MD, Pawan Prasher MD, James McCulley MD, R. Wayne Bowman MD.

University of Ulsan College of Medicine

Three-Year Follow-up after LASIK in Eye with Extremely Thin Corneal Bed Hidemasa Torii, MD, Kazuno Negishi, MD, Murat Dogru, MD, Takefumi Yamaguchi, MD,

Corneal Effects of 1.5% Levofloxacin Ophthalmic Solution (IQUIX®) in Humans Mark B. Abelson, MD1,2 Gail Torkildsen, MD2; Aron Shapiro2; Ingrid Lapsa2.

First 10 Cases with 150 kHz Intralase Enabled Keratoplasty (IEK) Compared to Standard Penetrating Keratoplasty (PK) Christopher L. Blanton, M.D. Financial.

Traumatic Wound Dehiscence After Corneal Keratoplasty

Corneal Biomechanics after Penetrating Keratoplasty and Descemet’s Stripping Automated Endothelial Keratoplasty Samer Hamada MRCOphth FRCS(Ed)1,3 Louai.

Mohamed Abdelrahman Awadalla,FRCS Magrabi Eye Hospital Cairo - Egypt

PERRY S. BINDER, MS MD* San Diego, California

Comparing Endothelial Cell Density after Sub-Bowman’s Keratomileusis and Photorefractive Keratectomy for the Treatment of Myopia Ryan T. Smith, MD Daniel.

Retrospective Study of 4 Cases That Developed Ectasia After LASIK (Intralase flaps) with Low-Risk Based on Ectasia Risk Score System Allan Luz, MD Colin.

Presentation transcript:

Mechanical Strength of of the Cornea after Femtosecond Laser Penetrating Keratoplasty NE Knox Cartwright, 1, 2 JR Tyrer, 2 J Marshall 1 1: Ophthalmology, King’s College London; 2: Mechanical Engineering, Loughborough University

Financial Disclosure John Marshall is a consultant for Advanced Medical Optics

Background The cornea has limited wound healing capacity resulting in an ~4 % incidence of post-keratoplasty wound dehiscence. Certain femtosecond lasers now have FDA approval for use in PK and the limited data available suggests that some of the complex incision profiles possible may be superior to conventional parallel sided trephinations.

Aim To compare quantitatively the biomechanical differences between differing femtosecond penetrating keratoplasty cut configurations.

Method Human eyebank corneas were obtained and transferred into a previously described organ culture model All surgery was performed using a 60 kHz Intralase femtosecond laser

Strain Measurements A custom built radial shearing speckle interferometer was used to measure the change in corneal strain following an increase in intraocular pressure from 15.0 to 15.5 mmHg before, after and one week following surgery.

Conventional Christmas tree Scarf Zig-square Strain Change at 1 Week Strain

Results at 1 Week Quantitative measurement was not possible from corneas with top hat and zig-zag PKs due to interface leak

Results at 1 Week IncisionStrain increase 135º Conical15 % * Top hat18 % * Christmas Tree20 % * Zig-square21 %* Conventional44 % Mushroom[wound leak] Zig-zag[wound leak] [*p < 0.05 compared to conventional]

Conclusions PK incisions with greater endothelial than epithelial diameter (top hat, scarf, zig- square, Christmas tree) are mechanically superior to conventional incisions Trephinations with greater epithelial than endothelial diameter (mushroom and zig- zag) are biomechanically inferior to parallel sided incisions

Contact Nathaniel KNOX CARTWRIGHT