Standardized color-coded corneal maps.
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Adult↗
Biomedical subjects
R P Gailitis
Publications and source records attributed to R P Gailitis.
Comparison of laser phacovaporization using the Er-YAG and the Er-YSGG laser.
OBJECTIVE: To study the interaction of the erbium (Er)-YAG (2.94 microns) and the Er-YSGG (2.79 microns) lasers with the human crystalline lens tissue. METHODS: Fresh human crystalline lens sections were used to measure the photovaporization threshold, rate, and damage zone of the two lasers. RESULTS: We found the photovaporization threshold for the Er-YAG and the Er-YSGG lasers to be 1.4 J/cm2 and 5.5 J/cm2, respectively. At 10 J/cm2, the photovaporization rate is 67.9 microns per pulse for the Er-YAG laser and 18.4 microns per pulse for the Er-YSGG laser. The increased rate of photovaporization as a function of radiant energy for the Er-YAG laser is almost twice that for the Er-YSGG. Damage zones for the Er-YAG laser ranged from 4 to 9 microns compared with 10 to 22 microns for the Er-YSGG. CONCLUSIONS: It is apparent that both lasers can adequately photovaporize human crystalline lens tissue and should be further studied for this purpose.
Cataract Extraction↗
A prototype erodible mask delivery system for the excimer laser.
PURPOSE: The authors developed an erodible mask delivery system for the argon-fluoride 193-nm excimer laser, which offers the possibility of correcting hyperopia and astigmatism as well as myopia. METHOD: Masks were made of polymethylmethacrylate on a quartz window, with intended corrections for myopia and hyperopia of 2.5 and 5 diopters (D). Ablations using the mask and control ablations using an expanding diaphragm were performed in 30 eyes of 15 pigmented rabbits with an Excimed UV200 laser (Summit Technology, Inc, Waltham, MA). The rabbits were followed for 134 days with regular biomicroscopy and retinoscopic examination by two observers. RESULTS: Ablations with the mask to correct myopia were successful and produced stable corrections, although the higher-power mask produced undercorrections. Hyperopic masks produced paradoxic myopic corrections, possibly due to the lack of a transition zone at the edge of the mask. Corneas ablated with the mask had less sub-epithelial haze than those ablated with the diaphragm at all examinations. Results of histopathologic examination showed epithelial hyperplasia over the ablation zone in all eyes. Dichlorotriazinyl aminofluorescein collagen staining showed subepithelial new collagen in all eyes, but there was no relation between the depth of ablation at any point on the cornea and the amount of new collagen deposited there. CONCLUSIONS: Myopic ablations are feasible with the erodible mask, although additional calibration is needed. Hyperopic ablations were unsuccessful with the current design. Corneas ablated with the mask may be clearer than corneas ablated with the diaphragm, possibly due to a smoother ablated surface. Regression of effect after laser ablation in the rabbit model is likely due more to epithelial hyperplasia than to stromal remodeling.
Animals↗
Solid state ultraviolet laser (213 nm) ablation of the cornea and synthetic collagen lenticules.
We used a Q-switched Nd:YAG laser with non-linear optical crystals to produce the 5th (213 nm) and the 4th (266 nm) harmonic frequencies. Using these two wavelengths, we ablated fresh porcine corneas and type I collagen synthetic epikeratoplasty lenticules. For the 213-nm ablation, radiant exposure was 1.3 J/cm2. The ablation rate was 0.23 micron per pulse for the epikeratoplasty lenticules. We examined all tissues with light microscopy, transmission electron microscopy, and scanning electron microscopy. Histology for the 213-nm ablation showed a clean ablation crater with minimal collagen lamellae disruption and a damage zone less than 1 micron. In comparison, the 266 nm radiation showed more charring at the edges with a damage zone approximately 25 microns deep with disruption of the stromal lamella. Our results show that this solid state UV laser is a potential alternative to the excimer laser for cornea surgery.
Aluminum Silicates↗
Current status of synthetic epikeratoplasty.
Many of the deficiencies with human tissue epikeratoplasty might be improved by the use of a suitable synthetic lenticule. Potential biomaterials for epikeratoplasty include collagen (types I, III, or IV), collagen-hydrogel copolymers, bioactive synthetics, and coated hydrogels. The biomaterial must be engineered to achieve strict specifications of optical clarity, support of epithelial migration and adhesion, permeability to solutes, and stability to corneal proteases. Attaching synthetic lenticules to the cornea without cutting Bowman's layer by adhesives, laser welding, or direct adhesion may also improve the efficacy of synthetic epikeratoplasty.
Animals↗
Laser welding of synthetic epikeratoplasty lenticules to the cornea.
We used a milliwatt continuous wave CO2 laser mounted on an operating microscope to study the feasibility of welding synthetic collagen epikeratoplasty lenticules to the cornea. In vitro studies and experimentation in rabbits and monkeys showed no welding effects using direct laser radiation with powers ranging from 17 mW to 1 W. Only tissue shrinkage was observed. Experiments using various adjunctive solders produced a temporary welding effect using 30% bovine serum albumin welded with a power of 35-45 mW, 325 microns spot size, moving the beam 5 mm/sec. The lenticules remained in place until the 4th postoperative day when epithelium grew underneath the lenticule, dislodging it. Histopathologic examination demonstrated epithelial migration over the solder displacing the epikeratoplasty lenticule and anterior stromal denaturization and disruption.
Animals↗