Femtosecond lasers were introduced in ophthalmology initially for flap creation for LASIK. This thesis describes a body of work undertaken by the author exploring the possibility of using these lasers in corneal and refractive surgery. The use of the femtosecond laser in corneal and refractive surgery offered the prospect of better precision with respect to their accuracy in depth cut, and the smoothest of lamellar interface. The development of multiple laser platforms allowed us to perform comparative studies in both ex vivo/animal and clinical studies and to explore the prospect of a new refractive procedure, lenticule extraction and also lenticule re-implantation. The laser proved to be accurate in its vertical depth cutting and following optimization was able to cut a smoothe lamellar interface. The clinical study showed the laser to be safe and effective. The comparative studies showed the superiority of the lower energy femtosecond laser on IOP rise, without compromising on clinical outcomes, which were the same for both lasers. Femtosecond laser lenticule creation was optimised in animal models and then shown to be safe and efficacious in a clinical study. The wound healing benefits of an 'all in one' femtosecond laser procedure were evident, in both animal as well clinical studies. Lenticule reimplantation was shown to be effective in both the rabbit and monkey models. The use of the femtosecond laser is set to increase in ophthalmology. The work in this thesis has provided fundmental ex vivo, animal and clinical benefits on the the use of femtosecond lasers in corneal and refractive surgery. It has also envisioned a concept of lenticule re-implantation for future clinical use.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:768141 |
| Date | January 2017 |
| Creators | Mehta, Jodhbir Singh |
| Publisher | City, University of London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://openaccess.city.ac.uk/21506/ |
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