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FEMTO‐DSEK: is endothelial cut possible?
Author(s) -
BAIKOFF G
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.1633.x
Subject(s) - lasik , stromal cell , endothelium , medicine , corneal endothelium , surgery , ophthalmology , cornea , pathology , endocrinology
The interest of the Femtosecond laser is its ability to cut parallel and regular corneal surfaces with great precision. The most common example we have is its routine use for lasik flaps for which the standard thickness is around 100µm. The difficulty of deep cuts with the Femtolaser gave rise to a number of irregularities, leading the author to use a posterior trans endothelial cut. The advantage of the VisuMax is that it applies very little pressure on the endothelium, the endothelial cells undergo very little alteration and with a cell loss of approximately 5% to 7%. After surgery (endothelial graft) the smoothness of the cut is not perfect (high resolution OCT) and a number of endothelial graft irregularities are visible. These irregularities can be due to the viscoelastic interface used to protect the endothelium when the aplanation cone comes into contact with the graft or else due to the bubbles that appear to be more important in the posterior stromal tissue than in the anterior one. The corneal graft is still swollen and the slack substance of this posterior tissue has a different reaction than when cutting a lasik flap in the anterior stromal tissue which is much denser. A certain number of methods are possible in order to try and reduce these irregularities. They will be discussed during the presentation.