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At least 19 recordsLinked to original sources
PubMed2006

[Ablation profiles in corneal laser surgery. Current and future concepts].

The predictability and quality of results in corneal refractive laser surgery are determined by a number of factors. Here, the calculation and choice of the ablation profile represent central elements. Our growing knowledge about the physical and optical properties of the eye in recent years has led to the development of different strategies in the generation of ablation profiles. This review describes the currently used ablation profiles with their advantages and disadvantages and provides an outlook on future methods for the calculation of ablation profiles.

Cornea↗
PubMed1989

Evolution of excimer laser corneal surgery.

Interest in the potential of the excimer laser for refractive surgery was generated by a series of experiments performed in IBM's T.J. Watson laboratories. The development of photoablative decomposition was applied to corneas with immediate implication for corneal refractive control. Scientific investigations demonstrated that submicron erosion ablation of material was possible without damage to remaining tissues. After refinement of the beam and analysis of thresholds, we subsequently demonstrated that healing of large ablated areas in rabbits and then primate eyes would occur without scar formation or loss of transparency. This prompted a number of commercial efforts to develop this device for both refractive and general corneal surgical applications. The early clinical investigations show that a predictable refractive change could be induced in a cornea and this change was stable over many months. Furthermore, the transparency of the cornea was unimpaired. These favorable early results have led to a number of clinical investigations of excimer laser corneal surgery including refractive keratectomy, a direct laser keratomileusis.

Animals↗
PubMed1994

ArF 193 nm excimer laser corneal surgery as a possible risk factor in cataractogenesis.

It was evaluated whether ArF 193 nm excimer laser corneal surgery represents a risk factor in cataractogenesis. For this purpose, 20 male albino rabbits underwent a photorefractive keratectomy and biochemical analyses on aqueous humour (hydrogen peroxide, ascorbic acid, and reduced and oxidized glutathione) and on lens (malondialdehyde, reduced and oxidized glutathione) were performed. In the aqueous humour of all treated animals a significant increase in hydrogen peroxide and in oxidized glutathione and a concomitant decrease in ascorbic acid and reduced glutathione concentration were observed. Moreover, all these variations were significantly correlated with the cumulative UV dose used. In the lens, after excimer laser corneal surgery, there was a dramatic loss of reduced glutathione and a parallel increase in oxidized glutathione levels. Malondialdehyde concentration was also increased, but only at the highest UV exposure. Moreover, all these variations were significantly correlated with the cumulative UV dose used. These findings demonstrate that the exposure of aqueous humour and lens to the secondary radiation generated after ArF 193 nm excimer laser corneal photoablative keratectomy induces biochemical modifications which are known to be markers of cataractogenesis.

Animals↗
PubMed2006

Pupil size and corneal laser surgery.

PURPOSE OF REVIEW: The role of scotopic pupil size as a factor in predicting night vision complaints is controversial. This review summarizes reports in the literature, some that have found and some that have failed to find a correlation with scotopic pupil size and night vision complaints. RECENT FINDINGS: Pupil-measuring devices are discussed along with informed consent issues and reports showing that wavefront aberrations increase with increasing pupil size. A new objective measuring device (Larson) showed a correlation with postoperative starbursts and pupil size and a decrease in starbursts with wavefront-guided treatments compared with conventional excimer laser treatments. Cortical adaptation allows many patients to adapt to their new night vision. Treatment options for those who remain symptomatic include drops to reduce pupil size and wavefront-guided retreatments. SUMMARY: Reports in the literature are conflicting, and refractive surgeons would be wise to inform their patients that large scotopic pupil size is a potential risk factor for night vision complaints. By doing this they will follow the recommendations in recent patient information brochures of both VISX (Santa Clara, California) and Alcon (Orlando, Florida) and on the United States Food and Drug Administration web site.

Cornea↗
PubMed1996

Excimer laser corneal surgery and free oxygen radicals.

Corneal photoablation with 193 nm argon fluoride excimer laser is a new technique for the treatment of refractive errors and for removing corneal opacities and irregularities. Ultraviolet radiation and thermal injury induce free radical formation in the tissues. The aim of this study was to confirm the production of free radicals by excimer laser photoablation in rabbits. The thermal changes of the posterior corneal surface were recorded during excimer laser photoablation. The lipid peroxide (LPO) levels and superoxide dismutase (SOD) activities of aqueous humour were measured after excimer laser keratectomy. The aqueous LPO levels were not changed after excimer laser ablation, but both the thermal increase in the cornea during the photoablation and the decreased aqueous SOD activities suggest that free radicals are formed in the cornea during excimer laser keratectomy, and that they may be responsible for some of the complications of excimer laser corneal surgery.

Animals↗
PubMed1997

[Effects of topical corticosteroids on subepithelial haze after excimer laser corneal surgery--objective and quantitative method for evaluating haze].

To examine the effectiveness of topical corticosteroids in decreasing subepithelial haze induced by excimer laser keratectomy, we performed excimer laser keratectomy on 24 eyes of 12 albino rabbits using a scanning excimer laser system (EC-5000, NIDEK, Japan). Topical dexamethasone 0.1% was applied topically to 8 corneas after surgery (steroid group), but not to the others (control group). Slit-lamp biomicroscopic examination and objective measurement of scattered light from subepithelial haze were performed before and 2, 4, 8 and 12 weeks after surgery, the rabbits were killed after 2 or 12 weeks and the eyes were examined histologically. In both groups, densitometric values of scattered light intensity increased up to 4 weeks after surgery, and then decreased gradually. However, the values of the steroid group were larger than those of the control group at all stages, and the values of the steroid group at 12 weeks after surgery were similar to preoperative values. There was statistically significant difference in scattered light intensity between the two groups (p < 0.005). Two weeks after surgery, the corneas of the control group showed epithelial hyperplasia and a remarkable increase in activated keratocytes and subepithelial fibrous tissues. However, in the steroid group these light microscopic findings could not be observed. At 12 weeks after surgery, the corneas of the control group retained a small amount of activated keratocytes and fibrous tissues, and those of the steroid group were normal. This study suggests that a short course of topical corticosteroids may be very effective in decreasing subepithelial haze after excimer laser corneal surgery.

Administration, Topical↗
PubMed1999

Effect of topical ascorbic acid on free radical tissue damage and inflammatory cell influx in the cornea after excimer laser corneal surgery.

OBJECTIVE: To evaluate the effect of topical ascorbic acid on oxygen free radical tissue damage and the inflammatory cell influx in the cornea after excimer laser keratectomy. METHODS: Five New Zealand white rabbits underwent bilateral phototherapeutic keratectomy with the 193-nm argon fluoride excimer laser. Following treatment, the right eye of each rabbit was treated with 10% ascorbic acid every 3 hours for 24 hours. The left eyes served as controls. After 24 hours, all animals were killed and their corneas were trephined and processed. Sections were stained with fast blue B and with hematoxylin-eosin. Oxidative tissue damage in the form of lipid peroxidation was detected by fluorescent peroxidized carbonyl compounds using a confocal laser scanning microscope. The quantity of these compounds was determined using the National Institutes of Health digital image analysis system. Statistical comparisons of lipid peroxidation and polymorphonuclear cell count between the ascorbic acid groups and the controls were performed using the Student t test. RESULTS: Lipid peroxidation and polymorphonuclear cell counts were significantly decreased in the superficial cornea of ascorbic acid-treated eyes compared with control eyes (P <.03 and <.02, respectively). CONCLUSIONS: Topical ascorbic acid application decreased oxygen radical tissue damage following excimer keratectomy; moreover, topical application of ascorbic acid was shown to reduce the acute inflammatory reaction efficiently. This suggests that topical ascorbic acid could be considered a complementary treatment in the pharmacological modulation after excimer laser corneal surgery. CLINICAL RELEVANCE: Corneal opacity may complicate excimer keratectomy. The use of an antioxidant to reduce tissue damage could help minimize postoperative stromal opacification.

Administration, Topical↗
PubMed1993

Arachidonic acid metabolites after excimer laser corneal surgery.

OBJECTIVE: We investigated early mediators of inflammation following excimer laser ablation in a rabbit cornea model. The ability of topical anti-inflammatory agents to influence these responses was also examined. METHODS: Adult New Zealand white rabbits were subjected to photorefractive keratectomy with a 193-nm argon fluoride excimer laser. Prostaglandin E2 and leukotriene B4 levels were measured using an enzyme immunoassay, and leukocyte infiltration was determined histologically. RESULTS: Prostaglandin E2 production was rapid and sustained, but we were unable to detect the presence of leukotriene B4. Relative to control, postoperative topical diclofenac sodium treatment caused a significant decrease in prostaglandin E2 levels and a significant increase in corneal leukocytes at 10 hours. Fluorometholone treatment did not significantly alter prostaglandin E2 levels but markedly depressed leukocyte ingress. CONCLUSIONS: Diclofenac reduces prostaglandin E2 levels but not leukocyte infiltration in the cornea following photorefractive keratectomy and thus may be useful clinically to reduce postsurgical pain.

Animals↗
PubMed1988

Human excimer laser corneal surgery: preliminary report.

The first human trial utilizing the argon fluoride excimer laser at 193 nm to produce a superficial keratectomy in ten human eyes has been described with the histopathological evaluation of four eyes and the longer gross appearance of six eyes at intervals extending to 10 months post-excimer laser treatment. The process of laser superficial keratectomy has proved to be one of the promising areas of surgical intervention for reconstructive or refractive keratoplasty in the future. Intensive investigations need to be undertaken on the corneal wound healing process following laser ablation as well as the nature, and long-term stability of the corneal excisions or induced refractive corrections. It is essential that the optimal laser parameters be established for the various refractive corrections and other corneal surgical techniques, and that pathophysiologic and histopathologic changes that have been induced by the excimer laser-corneal tissue interaction in animals and humans be critically and extensively analyzed.

Adult↗