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Laser welding in penetrating keratoplasty and cataract surgery in pediatric patients: early results

Session Details

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        

Abstract Details

Purpose:

To evaluate the efficacy of diode laser welding to close corneal wounds in keratoplasty and cataract surgery in pediatric patients.

Setting:

Ophthalmology Department, Bambino Gesł Children’s Hospital, Rome, Italy

Methods:

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.

Results:

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.

Conclusions:

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.

Financial Interest:

NONE