Laser welding of synthetic epikeratoplasty lenticules to the cornea

Abstract

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.