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Intralase-Enabled Keratoplasty (IEK):

LASER revolutionizes corneal transplants for patients suffering from severe corneal disease or damage.

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INTRALASE-ENABLED KERATOPLASTY

Intralase FS Laser

1. CORNEA CUT
Using an "inside-out" process, the IntraLase laser's infared light beam, generating 60,000 pulses per second, is precisely focused to a point within the cornea where bubbles are formed to gently create an incision.

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2. SURGEON-DESIGNED INCISIONS
The surgeon programs the laser to create precisely shaped incisions forming individualized edges of both the patient's cprnea and transplanted tissue, which fit together like a puzzle.

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3. CORNEA IMPLANTED
These precise incisions may result in a more stable graft that requires fewer sutures. The sutures may be removed earlier (after only six months in initial cases) and patients may achieve faster full visual recovery. Shaped incisions may be up to seven times stronger, greately reducing the risk of displacement.

TREPHINE METHOD

TREPHINE METHOD - A
TREPHINE METHOD - B

On April 13th, 2011, Dr. Robert McCulloch became the first ophthalmologist in Arizona to perform a blade-free all laser corneal transplant or Intralase-Enabled Keratoplasty (IEK). Dr. McCulloch has treated patients from Glendale, Phoenix, Scottsdale, Arrowhead, Goodyear and other areas in Arizona.

The advanced IntraLase® FS Laser is the first laser in the U.S. used to create innovative corneal incisions for full-thickness corneal transplants, representing the greatest technological breakthrough in corneal transplantation in over 50 YEARS. The ultra-fast femtosecond laser allows Dr. McCulloch to create precisely shaped incisions that enable the recipient and transplant tissues to fit together much like a puzzle.

This optimized wound architecture provides:
1) A more stable graft and...
2) Fewer sutures leading to...
3) Faster healing and visual recovery.

Laser Replaces Traditional "Cookie Cutter" Blade

Before the advent of IEK technology, corneal transplants were traditionally performed using a handheld, bladed "cookie cutter" called a trephine that is stamped onto the cornea to make a circular incision with straight, vertical edges. The corneal tissue is lifted resulting in a simple, plug-shaped tissue graft. With trephine preparation, the transplanted graft typical requires extensive suturing. These sutures stay in the eye for one year or longer, and patients generally do not achieve full visual recovery for at least a year, due to increased astigmatism.

Patients Benefit From Laser's Safety, Precision and Effectiveness

In IEK, the IntraLase® FS Laser is programmed by the surgeon to create precisely shaped, interlocking incisions in both the patient's diseased cornea and the transplant tissue. Then, the laser's infrared light beam is precisely focused to a point within the cornea where microscopic bubbles are formed to establish the incision. The laser is able to create complex incisions that are impossible for the manual, handheld trephine.

By creating incision edges that fit together in an interlocking design, the graft is more stable and heals faster. Some important advantages of IEK are:

  • Fewer and/or looser sutures are needed to keep the IEK incised graft in place.
  • Sutures are removed much earlier compared to one year or longer with traditional trephine-initiated keratoplasty.
  • Patients achieve their full vision faster and return to work sooner.
  • The risk for displacement of the graft is significantly reduced as shaped incisions have demonstrated a seven-fold increase in strength.

Cornea transplants may be compared to furniture for simple illustration. A poor quality piece of furniture may have boards simply nailed together at the ends. As one knows, after some stress the boards loosen, lose strength and eventually fall apart. A more extravagant and sturdy piece of furniture may have boards that are dovetail joined together.

The standard trephine corneal transplant surgery may be considered similar to straight nailed joints. The standard wounds will not carry the same strength. Additionally, they may not have perfectly matching surfaces, leading to much corneal irregularity and astigmatism. IEK wounds are similar to dovetailed joints as the interlocking corneal tissues provide greater surface area to heal in a more precisely aligned fashion. This should lead to greater wound strength and reduced corneal astigmatism.

About Corneal Transplantation

Corneal transplantation has restored sight to thousands who otherwise would be blind due to corneal injury, infection, or inherited corneal disease or degeneration. Corneal transplantation replaces a diseased or scarred cornea with a new one by having the central portion of the cornea surgically removed and replaced with corneal tissue donated through an eye bank. In 2005 more than 105,000 corneal transplants were performed annually worldwide, according to EEBA 2005 Annual Statistics.

If you are interested in learning more, feel free to visit our locations near Glendale, Scottsdale, Phoenix, Arrowhead, Goodyear and other areas in Arizona.

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