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KMID : 0213520130270020120
Korean Journal of Ophthalmology
2013 Volume.27 No. 2 p.120 ~ p.125
Lower Energy to Make a Corneal Flap with a 60 kHz Femtosecond Laser Reduces Flap Inflammation and Corneal Stromal Cell Death But Weakens Flap Adhesion
Kim Jae-Yong

Joo Sung-Woo
Sunwoo Jung-Hae
Kim Eun-Soon
Kim Myoung-Joon
Tchah Hung-Won
Abstract
Purpose: To compare corneal flaps created in rabbits with a 60 kHz femtosecond (FS) laser using different levels of raster energy and to measure early inflammation, corneal stromal cell death, and late postoperative adhesion strength.

Methods: Sixty rabbits were divided into three groups of 20 each. A flap 110 ¥ìm thick and 9.0 mm in diameter was made in one eye of each rabbit at raster energies of 0.7 ¥ìJ, 1.1 ¥ìJ, and 2.4 ¥ìJ. Histopathological evaluation for inflammation and apoptosis using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was performed at 4 and 24 hours after flap creation. The adhesion strength of the flaps was measured with a tension meter at 1 and 3 months.

Results: Twenty four hours after flap creation, the 2.4 ¥ìJ group had more inflammatory and CD11b-positive cells than the 0.7 and 1.1 ¥ìJ groups. The number of TUNEL-positive cells increased with raster energy at 4 and 24 hours. The grams of force (gf) needed to detach the flaps at 3 months was significantly higher in 2.4 ¥ìJ group (170 gf) than in 0.7 ¥ìJ group (97.5 gf) and 1.1 ¥ìJ group (100 gf, p = 0.03).

Conclusions: Using raster energy lower than 1.1 ¥ìJ to make a flap with a 60 kHz FS laser decreases inflammatory cell infiltration and corneal stromal cell death in the central cornea but may result in a weaker flap than using higher raster energy (2.4 ¥ìJ).
KEYWORD
Apoptosis, Femtosecond laser, Flap inflammation, Tissue adhesions
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