Photochemical keratodesmos as an adjunct to sutures for bonding penetrating keratoplasty corneal incisions☆☆☆
Accepted 18 February 2004.
Abstract
Purpose: To evaluate the benefit of photochemical keratodesmos (PKD) in acute wound closure of penetrating keratoplasty (PKP) corneal incisions in vivo.
Setting: Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Methods: Penetrating keratoplasty incisions were performed in both eyes of 6 New Zealand white rabbits, followed by application of 1.5 mM rose bengal dye at the wound edges. The incision in 1 eye of each rabbit was irradiated with neodymium:YAG laser light at 532 nm and fluence of 40 J/cm2; the contralateral control eye was untreated. Intraocular pressure at which fluid leaked at the edges (IOPL) was determined immediately after surgery.
Results: The mean IOPL was 410 mm Hg ± 70 (SD) in the PKD-treated eyes and 250 ± 150 mm Hg in the unirradiated eyes. The difference was statistically significant by paired t test (P<.05).
Conclusions: Photochemical keratodesmos may be a useful adjunct to sutures for approximating PKP corneal incisions in the immediate postoperative period. This process does not induce high temperature, and thus denaturation can be avoided and structural integrity restored.
aMassachusetts Eye and Ear Infirmary and the Schepens Eye Research Institute, Massachusetts General Hospital, Boston, MA, USA
bWellman Laboratories of Photomedicine, Harvard Medical School, Boston, MA, USA
Reprint requests to Dimitri T. Azar, MD, Director, Corneal and Refractive Surgery Services, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA.
☆ None of the authors has a financial interest in any product mentioned.
☆☆ Supported by the DoD Medical Free Electron Laser Program, contract number F 49620-01-1-0014, and the DoE, contract number DoE-FG02-91ER61228.
ABSTRACT