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| Shahzad I. Mian, M.D., assistant professor and Principal Investigator of the FLAK study. |
Early results show laser—developed at U-M for eye surgeries—improving corneal transplant outcomes
Nearly 15 years ago, researchers at Kellogg were first
to discover that the ultrafast or femtosecond laser, then
used for industrial purposes, had great potential for eye
surgeries that traditionally required a surgical blade.
Faculty from Kellogg and the College of Engineering
explored the laser’s surgical applications, and today it
is used worldwide for LASIK surgery.
Now, faculty hope for the same success in applying this exceptionally fast and precise laser to corneal transplant surgery.
Physician–scientists at Kellogg are conducting a two-year pilot program — called the FLAK (Femtosecond Laser-Assisted Keratoplasty) study — which uses the femtosecond laser to perform full thickness corneal transplants.
“We hope that with the use of the femtosecond laser, patients will have better vision, faster recovery of vision, and stronger wound construction that will provide more resistance to injury in the future,” says Shahzad I. Mian, M.D., assistant professor and Principal Investigator of the FLAK study.
While lasers have been effective in eye surgeries for decades, they were not used for corneal transplants until the femtosecond laser was shown to be a superior cutting tool to the trephine, the cookie cutter-like knife currently used for transplants. “The advantage of this laser is that it allows the surgeon to focus the laser energy at a particular depth and then rapidly cut the tissue at that depth without causing any injury to the surrounding tissue,” says Dr. Mian. “It also allows the surgeon to pattern these cuts into shapes — such as a mushroom, a top hat or a zig zag — that allow for customized overlap between the donor’s corneal tissue and the patient’s corneal tissue.”
Because of the speed and precision of the femtosecond
laser, the study results to date for corneal transplant
surgery have been very encouraging, according to
Dr. Mian. If these results hold true, a larger, multicenter
clinical trial comparing this procedure to the
traditional method could follow.
The cornea is the clear, dome-shaped tissue covering the front of the eye. It is about the size of a dime and the thickness of a credit card. If the cornea becomes distorted in shape, or scarred or hazy from disease or injury, the light rays passing through it are distorted and vision is reduced. In some cases, corneal transplant surgery is necessary to replace the damaged cornea with a healthy donor cornea to restore good vision.
Ophthalmologists perform more than 35,000 of these sight-saving procedures each year in the United States and, of all transplant surgeries done today, corneal transplants are the most common and most successful. Donor corneas are provided by eye banks and come from deceased individuals who arranged for donation prior to death or whose families gave consent.
For more information, see the Cornea and External Disease, Cataract and Refractive Surgery Clinic at the Kellogg Eye Center.
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