Role of Femtosecond Laser in Intra Corneal Rings Implantation
Hisham Abdulmalik Abdulrahman;
Abstract
ICRS are important to the future of refractive surgery because they allow us to correct ametropia (low-moderate myopia, keratoconus) without making anatomical changes directly to the central optical pathway.
The ICRS are designed to improve the outcome of corneal refractive surgery by reducing the effect of corneal wound healing and by maintaining the positive corneal asphericity.
Concerning the advantages and complications of ICRS, the ICRS have the advantages of reversibility, safety, predictability, and effectively reduced or eliminated mild myopia (-1.0to-3.50D). The refractive effect was stable over time.
Regarding the complications of the ICRS, they consist of intraoperative and postoperative complications.
The intraoperative complications occurred more frequently at the early stages of the clinical trial including anterior corneal perforation and posterior one. This perforation healed spontaneously without suturing and no loss of BSCVA. Improved surgical training may reduce intraoperative complication.
Focal white deposits that appear adjacent to the ring segments were thought to be lipid deposits and may be have come from stressed keratocytes, which are known to produce lipids.
As to keratoconus, the preliminary investigation has demonstrated promising results in applying ICRS; micro-thin prescription inserts seem to provide a viable method for treating clear corneal keratoconus for patients who are contact lens intolerant. The corneal steepening and astigmatism associated with keratoconus were reduced, and visual acuity was improved with treatment in almost all cases.
One recent and interesting technical development in laser refractive surgery is the emergence of ultrashort pulse lasers. The femtosecond laser is a focusable infrared laser using pulses in the femtosecond (10−15 s) duration range. This laser delivers closely spaced spots that may be focused at a preset depth to photodisrupt tissue within the corneal stroma.
The femtosecond laser has several advantages over the mechanical method for ICR channel creation in treatment of keratoconus, post-LASIK keratectasia and pellucid marginal corneal degeneration. Because laser energy is delivered optically to a precise depth, tunnel resections and entry incisions are highly reproducible, with little risk of corneal perforation. Also, the channel size and depth as well as the side-cut position may be changed as desired.
The ICRS are designed to improve the outcome of corneal refractive surgery by reducing the effect of corneal wound healing and by maintaining the positive corneal asphericity.
Concerning the advantages and complications of ICRS, the ICRS have the advantages of reversibility, safety, predictability, and effectively reduced or eliminated mild myopia (-1.0to-3.50D). The refractive effect was stable over time.
Regarding the complications of the ICRS, they consist of intraoperative and postoperative complications.
The intraoperative complications occurred more frequently at the early stages of the clinical trial including anterior corneal perforation and posterior one. This perforation healed spontaneously without suturing and no loss of BSCVA. Improved surgical training may reduce intraoperative complication.
Focal white deposits that appear adjacent to the ring segments were thought to be lipid deposits and may be have come from stressed keratocytes, which are known to produce lipids.
As to keratoconus, the preliminary investigation has demonstrated promising results in applying ICRS; micro-thin prescription inserts seem to provide a viable method for treating clear corneal keratoconus for patients who are contact lens intolerant. The corneal steepening and astigmatism associated with keratoconus were reduced, and visual acuity was improved with treatment in almost all cases.
One recent and interesting technical development in laser refractive surgery is the emergence of ultrashort pulse lasers. The femtosecond laser is a focusable infrared laser using pulses in the femtosecond (10−15 s) duration range. This laser delivers closely spaced spots that may be focused at a preset depth to photodisrupt tissue within the corneal stroma.
The femtosecond laser has several advantages over the mechanical method for ICR channel creation in treatment of keratoconus, post-LASIK keratectasia and pellucid marginal corneal degeneration. Because laser energy is delivered optically to a precise depth, tunnel resections and entry incisions are highly reproducible, with little risk of corneal perforation. Also, the channel size and depth as well as the side-cut position may be changed as desired.
Other data
| Title | Role of Femtosecond Laser in Intra Corneal Rings Implantation | Other Titles | دور الفيمتوسكند ليزر في زراعة حلقات القرنية | Authors | Hisham Abdulmalik Abdulrahman | Issue Date | 2015 |
Attached Files
| File | Size | Format | |
|---|---|---|---|
| G12170.pdf | 400.42 kB | Adobe PDF | View/Open |
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