Laser Induced Thermal Keratoplasty

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Abstract
A technique of corneal surgery that is thermally induced and relatively nonenvasive has been studied by the authors, and the preliminary results of the thermal keratoplasty performed on live rabbits are reported here. A carbon dioxide laser was used with simple optical and pointing systems to thermally induce several arbitrary patterns of corneal reformation. Endothelial photographs were taken before the procedure and then again ten days after. They indicated no damage in the Descemet's membrane nor was there damage observed to the endothelium. As much, as 14 "diopters" of change occurred in the corneal keratometry with both positive and negative directions signs. The magnitude and direction of the change were recorded as functions of the pattern of the therapy produced and the laser energy deposited in the stroma. Any corneal reformation was tracked as a function of time subsequent to the procedure. A-minor decay was observed within the first three days of the procedure and the majority of the reformations have maintained at the time of this writing. Since radiation at this wavelength is highly attenuated and absorbed in cornea, no change was observed beyond mid-stroma and the lens and retina appeared uneffective. The authors believe that this technology will be a significant contributor to corneal refractive procedures in the near future. Unlike any refractive surgery currently practiced, this technology may lead to a procedure that: 1) is reversible, 2) is re.eatable, 3) stren thens rather then weakens the cornea, 4) is a..arentl more stable, 5) is more flexible in the types of corneal curvature changes it can produce, 6) results in very clean mires, 7) is painless, and 8) results in total corneal clarity.

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