Purpose: To examine the efficacy and reproducibility of CO2 laser soldering of corneal cuts using real-time infrared fiber-optic radiometric control of tissue temperature in bovine eyes (in vitro) and to evaluate the duration of this procedure in rabbit eyes (in vivo). Methods: In vitro experiment: a 6-mm central perforating cut was induced in 40 fresh bovine eyes and sealed with a CO2 laser, with or without albumin soldering, following placement of a single approximating nylon suture. A fiber-optic radiometric temperature control system for the CO2 laser was used. Leaking pressure and histological findings were analyzed and compared between groups. In vivo experiment: following creation of a central perforation, 6 rabbit eyes were treated with a CO2 laser with albumin solder and 6 rabbit eyes were treated with 10-0 nylon sutures. The amount of time needed for completion of the procedures was compared. Results: In vitro experiment: effective sealing was achieved by CO2 laser soldering. Mean (± SD) leaking pressure was 109 ± 30 mm Hg in the bovine corneas treated by the laser with albumin solder compared to 51 ± 7 mm Hg in the sutured control eyes (n = 10 each; p < 0.001). Mean leaking pressures were much lower in the corneal cuts sealed only with the laser without albumin solder (48 ± 12 mm Hg) and in the cuts sealed only with albumin without laser welding (6.3 ± 4 mm Hg) than in the cuts treated with laser welding and albumin solder. In vivo experiment: mean surgical time was 140 ± 17 s in the laser-treated rabbits compared to 330 ± 30 s in the sutured controls (n = 6; p < 0.001). A histopathological study of the rabbit corneas 1 day after laser soldering revealed sealed corneal edges with a small gap bridged by coagulated albumin. The inflammatory reaction was minimal in contrast to the sutured controls. No thermal damage was detected at the wound edges. Conclusions: CO2 laser soldering combined with the fiber-optic radiometer is an effective, reliable, and rapid tool for the closure of corneal wounds, and holds advantages over conventional suturing in terms of leaking pressure and surgical time.

Keywords:
Corneal laser soldering, CO2 laser, Controlled temperature welding, Fiber-optic radiometry, Infrared fibers, Leaking pressures
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2013
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