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Session Title: Cornea Surgical II
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 08:56
Venue: Forum (Ground Floor)
First Author: : L.Buzzonetti ITALY
Co Author(s): : L. Menabuoni P. Capozzi R. Pini
To evaluate the efficacy of diode laser welding to close corneal wounds in keratoplasty and cataract surgery in pediatric patients.
Ophthalmology Department, Bambino Gesł Childrens Hospital, Rome, Italy
Seven eyes of 5 patients (mean age 8.1?5.3 ?SD? years; range, 1 to 15 years) underwent surgery for congenital cataract (Group 1) and 5 eyes of 5 patients (mean age 10.6?3.3 ?SD? years; range, 6 to 15 years) underwent penetrating keratoplasty assisted by femtosecond laser (Group 2). The surgical operations were followed by laser-assisted closure of the corneal wounds by diode laser welding of the stroma. This procedure is based on a photothermal effect: a water solution of Indocyanine Green (ICG) is inserted in the surgical wound, in order to stain the corneal tissue walls. The stained tissue is then irradiated with a low power infrared diode laser, delivering laser light through a 300-µm core diameter optical fiber. In Group 1 no standard suturing was used, while in Group 2 the donor was sutured upon the recipient using 8 single stitches or a running suture (12 passages) in nylon 10.0. Laser welding was then used as an adjunct to the traditional suturing procedure.
The follow-up evidenced a perfect adhesion of the laser welded tissues; there were no collateral effects and the restoration of the treated tissues was optimal. The Seidel test showed no wound leakage during the follow-up examinations. Post-operative astigmatism did not show statistically change post cataract surgery from the first post-operative day, while it shifted moderately 3 months after keratoplasty.
This procedure enables an immediate closure of the wounds: it is thus possible to reduce or to substitute the use of surgical corneal suture. This is of particular interest in children, because the immediate healing closure improves refractive outcome and anti-amblyopic effect; moreover this procedure avoids several general anesthesia necessary for postoperative suture management.
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