METHOD OF FORMING A CORNEAL-PROSTHETIC COMPLEX USING A FEMTOSECOND LASER Russian patent published in 2023 - IPC A61F9/07 A61F9/08 A61F2/14 

FIELD: medicine; ophthalmology.

SUBSTANCE: donor cornea is placed on the artificial anterior chamber (AAC), after closing the mechanism of which it is filled with a balanced saline solution to the state of corneal normotonia. The centration is performed and optimal compression of the cornea is achieved. The femtodissection of the cornea is performed with the formation of an intrastromal pocket (ISP) and the entrance tunnel into it, corresponding to the parameters of the implanted supporting part of the keratoprosthesis, and the angle of the plane of the formation of the entrance tunnel with respect to the plane of the ISP, equal to 90°. The cornea fixed in the AAC is placed under the operating microscope. Separation of the remaining collagen bridges in the area of the ISP is carried out, the supporting part of the keratoprosthesis is implanted into the formed ISP, through corneal trepanation is performed. The corneal-prosthetic complex is placed in the trepanation bed of the recipient and fixed with interrupted sutures. A Femto LVD Z8 femtosecond laser with an energy level of at least 100% is used, ISP is formed at a depth of 2/3 of the entire thickness of the cornea, oval in shape, the major axis of which is 6.5 mm, the minor axis is 5.5 mm. The entrance tunnel is formed on the right at a distance of 0.2 mm outward from the edge of the formed ISP, with a size of 5.5 mm, after the formation of the ISP, the cornea is simultaneously trepanned for 2/3 of the thickness of the cornea with a diameter of 8.3 mm. Then the cornea is left uncut for 50 mcm and trepanation is completed to the remaining depth. After the end of the operation of the femtosecond laser, the supporting part of the keratoprosthesis is implanted in the ISP, the entrance tunnel is fixed with interrupted sutures. The remaining uncut portion of the cornea is cut with a blade and scissors, separating the formed corneal-prosthetic complex from the underlying tissues of the donor's cornea. The resulting complex is placed in a medium for storing the cornea until transplantation.

EFFECT: method makes it possible to form a uniform ISP on the donor cornea, control the depth and optimal incision profile, which ensures minimal risk of corneal perforation, reduces the risk of keratoprosthesis protrusion in the future, and allows simultaneous trepanation of the harvested cornea with ISP without additional manipulations and risks of damage to the keratoprosthesis base plate.

1 cl, 1 ex, 3 dwg