Nonmechanical poterior lamellar keratoplaty uing the femtoecond laer (femto-plak) for corneal endothelial decompenation

Purpoe To ae the potential of a hort puled laer to cut a poterior graft and bed for poterior lamellar keratoplaty (PLAK). Deign Experimental tudy. Method Uing the laer FEMTEC (20/10 Perfect Viion, Heidelberg, Germany), poterior lamellar diection (wave length approximately 1 μm, pule energy < 10 μJ, pot ize <10 μm, repetition rate 12.5 kHz, 6-mm–7 mm diameter, 31 and 90 ) were performed in 18 frehly enucleated porcine eye and 10 human donor cornea tarting from the anterior chamber and ending with the lamellar bed. Reult Before removal, 50-μm to 500-μm-thick flap were delineated by partly confluent ga bubble (maximum 2-mm long) with minute tiue bridge (typically 5- to 10-μm) in between. canning electron microcopy diplayed mooth cut urface and rectangular corner with minor remaining tiue bridge (approximately 5 μm). By tranmiion electron microcopy, the cut edge were lined by a delicate, electron-dene layer (5 nm–10 nm in width) and eentially normal adjacent collagen fiber. Concluion Femtoecond laer technology eem to offer a promiing approach to minimally invaive poterior lamellar keratoplaty (femto-PLAK) through mall tunnel inciion in corneal endothelial dieae.