Eye Surgery: Incision Closure Without Stiches

Eye Surgery: Incision Closure Without Stiches

Until now closure of surgical incisions in the eye was achieved by means of small sutures, much like most surgeries. Even with the great advancements in new surgical procedures and new technology to treat eye diseases and all other diseases in man, suturing techniques have been mostly the same as they were centuries ago. A new study published in the Journal of Biomedical Optics explores the use of a novel technique of eye incision closing using laser technology.

Prof. Abraham Katzir, of the Applied Physics Group at Tel Aviv University’s School of Physics and Astronomy, has been trying to optimize a new technique he developed called “laser welding”. This technology uses laser to heat incision edges in a precisely controlled manner using a feedback mechanism for optimal wound closure. The advantages to the classic needle-and-thread sutures include faster healing, decreased risk of infection, and less scarring. These are specially important for eye microsurgery as the tissues are very delicate.

To this end, Katzir’s research group has devised a type of optical fibers made of silver halides that are transparent to infrared light. They are used to deliver an infrared laser beam, which carefully heats the edges of an incision spot by spot. At the same time, infrared light from the heated spot is checked by an infrared detector, monitoring the temperature at each spot. As a result, the desired temperature is achieved (e.g. 140-150 degrees F) making a strong bond possible without overheating.

In previous works, he and the research group have done tests in skin incisions with much success. Now the team of researchers is conducting corneal transplant experiments on live animal models using “laser welding” for wound closure. A corneal transplant can restore vision in people suffering from corneal conditions, such as bulging corneas, Fuchs’ dystrophy, thinning corneas, corneal scarring caused by infection or injury, cataracts, corneal swelling, corneal ulcers, or complications caused by previous eye surgery.

As new minimally invasive surgeries are being developed, surgeons face increasing difficulties in suturing incisions in those procedures. “Laser welding” can not only be used in eye or skin incision closure, but also in endoscopic surgery as it is based on thin and flexible optical fibers that can easily be inserted through the endoscope.

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