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Volume 11 (5) * September/October 1995 * Original Article (abstract)

Holmium Laser Thermal Keratoplasty of 10 Poorly Sighted Eyes

BACKGROUND

The holmium:YAG laser shrinks stromal collagen and changes corneal refractive power, reportedly without recurrent or persistent epithelial defects, stromal necrosis, or damage to the epithelium and endothelium observed with some other thermokeratoplasty techniques.

METHODS

We studied the safety of the holmium:YAG laser using various patterns and energy densities after treating 12 poorly sighted eyes, two immediately prior to corneal transplantation and 10 followed for a mean period of 90 days (range, 60 to 180 days). Visual acuity, intraocular pressure and inflammation, central corneal endothelial cell density and thickness, and intraocular structures of the eye were indices evaluated regularly. Patients were also assessed for specific symptoms during the postoperative period.

RESULTS

There were no problems with epithelial healing and no stromal necrosis or evidence of endothelial damage; no significant differences were noted in any of the endothelial cell indices examined. A mean change in corneal curvature of 1.10 diopter (D) was achieved, but varying amounts of regression of this effect was noted.

CONCLUSION

Holmium:YAG laser thermal keratoplasty appears to be safe over a follow up of up to 180 days. Corneal refractive changes on the order of 1.05 D can be achieved using the parameters employed in this study. Whether or not larger, persistent corneal refractive change can be achieved with a holmium:YAG laser remains to be determined. [J Refract Surg. 1995;11:358-365.]

AUTHORS

From the Doheny Eye Institute and the Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, Calif (Drs Ariyasu and McDonnell and Ms Garbus) and Sunrise Technologies, Inc, Fremont, Calif (Drs Sand and Berry and Messrs Menefee, Rose, and Hennings).

This study was supported in part by a grant from the Autry Foundation, Los Angeles, Calif; by the National Eye Institute/NIH core grant EY03040, Bethesda, Md; a grant from Sunrise Technologies; and an unrestricted grant from Research to Prevent Blindness, Inc, New York, NY. Dr McDonnell is a Research to Prevent Blindness William and Mary Greve International Research Scholar.

Dr Sand has a proprietary interest in Sunrise Technologies, Inc; Dr Berry and Messrs Menefee, Rose, and Hennings are employees of Sunrise Technologies, Inc.

Reprint requests should be addressed to Peter J. McDonnell, MD, Doheny Eye Institute, 1450 San Pablo St, Los Angeles, CA 90033.

Received: March 28, 1994
Accepted: December 15, 1994

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