Corneal Tissue Resection Using Non-Continuous Laser Incisions
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Solution Overview
Problem
The traditional technique for penetrating keratoplasty using femtosecond surgical lasers poses challenges in transferring recipient corneas without exposing them to contaminants, as the entire resection pattern must be completed in the operating room to prevent tissue dislodgment during transfer.
Innovation Solution
A system employing a surgical laser with a focusing assembly and controller to create non-continuous initial incisions with uncut gaps in the resection pattern, allowing for partial incision in a preparation room and completion with a bladed or blunt instrument in the operating room, maintaining tissue integrity and protection from contaminants during transfer.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the entire resection pattern is completed in the operating room using femtosecond laser, then tissue dislodgment is prevented, but the femtosecond laser occupies valuable operating room space and increases device complexity
Solution Approach 1:
The resection pattern is divided into two parts: initial incisions made with femtosecond laser in the preparation room, and completion incisions made with manual instruments in the operating room. This segmentation allows the complex laser procedure to be split between two locations, reducing operating room equipment requirements while maintaining tissue stability through the protected corneal wallet technique.
Solution Approach 2:
The initial incisions and corneal wallet creation are performed in advance in the preparation room before the patient is transferred to the operating room. This preliminary action reduces the time the femtosecond laser needs to occupy the operating room and allows most of the resection pattern to be completed beforehand, with only final incisions requiring the operating room setting.
2Device complexity
If the femtosecond laser is placed in the surgical preparation room, then operating room space is freed, but extreme care must be taken to prevent contamination of internal corneal tissues during transfer
Solution Approach 1:
A corneal wallet (thin film structure) is created to enclose the internal corneal tissues during transfer from the preparation room to the operating room. This protective envelope prevents contamination of the exposed corneal stroma while allowing the femtosecond laser to be positioned in the preparation room, thereby freeing operating room space.
3Object-affected harmful factors
If non-continuous initial incisions with uncut gaps are made, then tissue protection during transfer is enabled, but additional manual instruments are required to complete the incisions
Solution Approach 1:
The incision process is segmented into laser-created initial incisions with intentional uncut gaps, followed by manual completion of the gaps using bladed or blunt instruments. This segmentation allows the majority of the incision to be made with the protective corneal wallet in place during transfer, while minimizing the need for complex laser equipment in the operating room.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables safe transfer of corneal tissue between preparation and operating rooms without risking dislodgment, ensuring the corneal tissue remains protected and reduces the need for extensive equipment in the operating room.
Implementation Method 1
a surgical laser emits a pulsed laser beam which is directed into the cornea by a focusing assembly
Implementation Method 2
The laser, unlike manual instruments, can be used to create full thickness corneal incisions
Data Source
Figure 1A~1B
Figure 1C~1D
Figure 1E~1F
AI summary
A system and method for resecting corneal tissue is disclosed. A resection pattern is selected for resecting corneal tissue. The resection pattern is incised in a cornea using a surgical laser, leaving one or more uncut gaps in the incised resection pattern. Any uncut gaps left in the resection pattern may thereafter be incised using an alternate surgical instrument.