Holmium Laser Thermokeratoplasty

Hamilton Moreira; Mauro Campos; Mark R. Sawusch; Jan M. McDonnell; Bruce Sand; Peter J. McDonnell

doi:10.1016/S0161-6420(93)31579-4

Holmium Laser Thermokeratoplasty

Hamilton Moreira, Mauro Campos, Mark R. Sawusch, Jan M. McDonnell, Bruce Sand, Peter J. McDonnell

Research output: Contribution to journal › Article › peer-review

66 Scopus citations

Abstract

Purpose: Corneal curvature can be altered by shrinking stromal collagen with a pulsed solid-state holmium:YAG laser in a procedure termed laser thermokeratoplasty. Methods: The authors performed laser thermokeratoplasty in 40 human cadaver eyes using a ring pattern of 32 spots, each spot having a diameter of 300 μm. Results: The amount of induced corneal steepening decreased as ring diameter was increased in 1 mm increments, with 22.2 ± 3.3 and 3.7 ± 2.0 diopters (D) of central steepening with diameters of 3 and 7 mm, respectively. Results of histologic examination showed a cone-shaped zone of increased stromal hematoxylin uptake extending posteriorly for 90% of stromal thickness. Energy levels greater than those needed to induce topographic changes produced limited endothelial injury in rabbit corneas and, in some cases, intraocular inflammation. A computerized, finite element model of the globe demonstrated central corneal steepening as a result of heat-induced stromal contraction to a depth of 75% corneal thickness. Conclusions: These data support previous studies indicating that central corneal topography can be modified by heating corneal stroma in a controlled fashion with the mid-infrared holmium:YAG laser.

Original language	English (US)
Pages (from-to)	752-761
Number of pages	10
Journal	Ophthalmology
Volume	100
Issue number	5
DOIs	https://doi.org/10.1016/S0161-6420(93)31579-4
State	Published - 1993
Externally published	Yes

ASJC Scopus subject areas

Ophthalmology

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10.1016/S0161-6420(93)31579-4

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title = "Holmium Laser Thermokeratoplasty",

abstract = "Purpose: Corneal curvature can be altered by shrinking stromal collagen with a pulsed solid-state holmium:YAG laser in a procedure termed laser thermokeratoplasty. Methods: The authors performed laser thermokeratoplasty in 40 human cadaver eyes using a ring pattern of 32 spots, each spot having a diameter of 300 μm. Results: The amount of induced corneal steepening decreased as ring diameter was increased in 1 mm increments, with 22.2 ± 3.3 and 3.7 ± 2.0 diopters (D) of central steepening with diameters of 3 and 7 mm, respectively. Results of histologic examination showed a cone-shaped zone of increased stromal hematoxylin uptake extending posteriorly for 90% of stromal thickness. Energy levels greater than those needed to induce topographic changes produced limited endothelial injury in rabbit corneas and, in some cases, intraocular inflammation. A computerized, finite element model of the globe demonstrated central corneal steepening as a result of heat-induced stromal contraction to a depth of 75% corneal thickness. Conclusions: These data support previous studies indicating that central corneal topography can be modified by heating corneal stroma in a controlled fashion with the mid-infrared holmium:YAG laser.",

author = "Hamilton Moreira and Mauro Campos and Sawusch, {Mark R.} and McDonnell, {Jan M.} and Bruce Sand and McDonnell, {Peter J.}",

note = "Funding Information: Originally received: October 27, 1992. Revision accepted: December 21, 1992. From the Doheny Eye Institute and the Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles. Supported by a grant from the Autry Foundation, Los Angeles, California. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.",

year = "1993",

doi = "10.1016/S0161-6420(93)31579-4",

language = "English (US)",

volume = "100",

pages = "752--761",

journal = "Ophthalmology",

issn = "0161-6420",

publisher = "Elsevier Inc.",

number = "5",

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TY - JOUR

T1 - Holmium Laser Thermokeratoplasty

AU - Moreira, Hamilton

AU - Campos, Mauro

AU - Sawusch, Mark R.

AU - McDonnell, Jan M.

AU - Sand, Bruce

AU - McDonnell, Peter J.

N1 - Funding Information: Originally received: October 27, 1992. Revision accepted: December 21, 1992. From the Doheny Eye Institute and the Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles. Supported by a grant from the Autry Foundation, Los Angeles, California. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.

PY - 1993

Y1 - 1993

N2 - Purpose: Corneal curvature can be altered by shrinking stromal collagen with a pulsed solid-state holmium:YAG laser in a procedure termed laser thermokeratoplasty. Methods: The authors performed laser thermokeratoplasty in 40 human cadaver eyes using a ring pattern of 32 spots, each spot having a diameter of 300 μm. Results: The amount of induced corneal steepening decreased as ring diameter was increased in 1 mm increments, with 22.2 ± 3.3 and 3.7 ± 2.0 diopters (D) of central steepening with diameters of 3 and 7 mm, respectively. Results of histologic examination showed a cone-shaped zone of increased stromal hematoxylin uptake extending posteriorly for 90% of stromal thickness. Energy levels greater than those needed to induce topographic changes produced limited endothelial injury in rabbit corneas and, in some cases, intraocular inflammation. A computerized, finite element model of the globe demonstrated central corneal steepening as a result of heat-induced stromal contraction to a depth of 75% corneal thickness. Conclusions: These data support previous studies indicating that central corneal topography can be modified by heating corneal stroma in a controlled fashion with the mid-infrared holmium:YAG laser.

AB - Purpose: Corneal curvature can be altered by shrinking stromal collagen with a pulsed solid-state holmium:YAG laser in a procedure termed laser thermokeratoplasty. Methods: The authors performed laser thermokeratoplasty in 40 human cadaver eyes using a ring pattern of 32 spots, each spot having a diameter of 300 μm. Results: The amount of induced corneal steepening decreased as ring diameter was increased in 1 mm increments, with 22.2 ± 3.3 and 3.7 ± 2.0 diopters (D) of central steepening with diameters of 3 and 7 mm, respectively. Results of histologic examination showed a cone-shaped zone of increased stromal hematoxylin uptake extending posteriorly for 90% of stromal thickness. Energy levels greater than those needed to induce topographic changes produced limited endothelial injury in rabbit corneas and, in some cases, intraocular inflammation. A computerized, finite element model of the globe demonstrated central corneal steepening as a result of heat-induced stromal contraction to a depth of 75% corneal thickness. Conclusions: These data support previous studies indicating that central corneal topography can be modified by heating corneal stroma in a controlled fashion with the mid-infrared holmium:YAG laser.

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Holmium Laser Thermokeratoplasty

Abstract

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