O.Yu. KOMAROVA¹, S.B. IZMAILOVA¹, S.V. NOVIKOV³, A.S. ZAVYALOV², A.V. SHATSKIKH¹, Kh.D. TONAEVA¹, I.N. SHORMAZ¹, M.V. ZIMINA¹

¹S. Fyodorov Eye Microsurgery Federal State Institution, 59а Beskudnikovsky Blvd, Moscow, Russian Federation, 127486

²PIC GPI RAS, Optosystems Ltd., 2 Promyshlennaya Str., Moscow, Troitsk, Russian Federation, 142190

³Scientific-experimental production «Eye microsurgery» Ltd., 59a Beskudnikovsky blvrd, Moscow, Russian Federation, 127486

  Komarova O.Yu. ― postgraduate student of the Department of Transplantation and Opto-Reconstructive Surgery of anterior segment of the eyeball, e-mail: ol.komarova91@gmail.com

Izmailova S.B. ― D. Sc. (medicine), Head of the Department of Transplantation and Opto-Reconstructive Surgery of anterior segment of the eyeball, tel. (499) 488-84-69, е-mail: lana-dok@mail.ru

Novikov S.V. ― Deputy Director General, tel. (499) 488-85-75, e-mail: snovikov@yandex.ru

Zavyalov A.S. ― Head of the Femtosecond Medical Laser Group, e-mail: zavyalov@optosystems.ru

Shatskikh A.V. ― PhD (medicine), Head of the Laboratory of Eye Pathology and Histology, pathologoanatomist, tel. (499) 488-85-05, e-mail: avsatik@yandex.ru

Tonaeva Kh.D. ― PhD (medicine), Head of the Eye Tissue Bank, tel. (499) 488-84-05, e-mail: onxd15@gmail.com

Shormaz I.N. ― doctor-ophthalmologist, tel. (499) 488-89-56, e-mail: irishor@yandex.ru

Zimina M.V. ― postgraduate student of the Department of Transplantation and Opto-Reconstructive Surgery of anterior segment of the eyeball, е-mail: marina_zimina@hotmail.com

The results are presented of an assessment of the technical feasibility of intrastromal femtosecond-laser-assisted keratopigmentation using a new gel implant based on the water-soluble polysaccharide and insoluble organic pigments of the CROMOPHTAL in the ex vivo experiment. Scientific-experimental company «Eye Microsurgery» Ltd created a new gel implant based on water-soluble polysaccharide and insoluble organic pigments of the CROMOPHTAL series, intended for insertion into the corneal tunnel to correct iris defects. On 7 donor eyes, a ring-shaped closed corneal tunnel was formed with a femtosecond laser FemtoVisum (the Corneal Tunnel program), into which 0.5 ml of a new gel implant was injected. At the end of the experiment, optical coherent tomography of the corneal of the cadaveric eye was performed on the OCT Visante device (Carl Zeiss, Germany), as well as a histological examination of the cornea. The successful fixation of the gel-colored substance in the space of the formed corneal tunnel was visually determined. The gel implant was evenly distributed in the corneal tunnel, it has a shielding effect. According to the results of histological examination, the performed intrаstromal tunnel with edge pigmentation (remains of the artificial pigment) is visualized. It can be concluded that the formation of the corneal tunnel by means of a femtosecond laser for the subsequent performance of the keratopigmentation procedure is a precision, predictable and safe process. The gel structure is capable of providing a stable compact fixation in the space of the corneal tunnel. Preliminary results indicate the advisability of further research on the properties of the new gel implant to assess biocompatibility and determine its usefulness in clinical practice.

Key words: keratopigmentation, femtosecond laser, iris defect, gel implant.

 (For citation: Komarova O.Yu., Izmailova S.B., Novikov S.V., Zavyalov A.S., Shatskikh A.V., Tonaeva Kh.D., Shormaz I.N., Zimina M.V. Surgical correction of iris defects by the method of intrastromal femtosecond-laser assisted keratopigmentation using a new gel implant based on a water-soluble polysaccharide and insoluble organic pigments of the CROMOPHTAL series. Practical Medicine. 2018)

REFERENCES

1. Zapuskalov I.V., Krivosheina O.I. Modern tendencies of reconstructive surgery of traumatic injuries of the anterior segment of the eye (literature review). SibGMU, Tomsk, Oftal’mokhirurgiya, 2013, no. 2, pp. 59-61 (in Russ.).
2. Pozdeeva N.A., Pashtaev N.P. Iskusstvennaya iridokhrustalikovaya diafragma v khirurgicheskom lechenii aniridii [Artificial iridogastrenic diaphragm in the surgical treatment of aniridia]. Cheboksarskiy filial FGBU “MNTK “Mikrokhirurgiya glaza”.
3. Choyce D.P. Semirigid corneal in lays used the managment of albinism, aniridia and ametropia. International Congress of Ophthalmology, 24the: Acta. San Francisco, 1982. Pp. 1230-1234.
4. Venger G.E. Vosstanovitel’naya khirurgiya raduzhnoy obolochki pri travmakh glaza i ikh iskhodakh: avtoref. dis. … d-ra med. nauk [Reconstructive surgery of the iris with traumas of the eye and their outcomes. Synopsis of dis. Dr med. sciences]. Odessa, 1984. 33 p.
5. Linnik L.F. Surgical tactics of removal of tumors of the vascular tract. Oftal’mokhirurgiya, 2006, no. 4, pp. 17-23 (in Russ.).
6. Fedorov S.N., Zuev V.K., Vagrov S.N. et al. Surgical correction of aniridia and defects of the iris. Oftal’mokhirurgiya, 1990, no. 2, pp. 20-22 (in Russ.).
7. Alio J.L., Alejandra M. Text and Atlas on Corneal Pigmentation. P. 31.
8. Alio J.L., Rodriguez A.E. Femtosecond-assisted keratopigmentation double tunnel technique in the management of a case of Urrets-Zavalia syndrome. Cornea, 2012, Sep, 31 (9), pp. 1071-1074.
9. Leigh A.G. Tattooing of the cornea. In: Duke-Elder S., ed. System of ophthalmology. Vol. VIII, Part 2. London: Henry Kimpton, 1965. Pp. 645-648.
10. Mannis M.J., Eghbali K., Schwab I.R. Keratopigmentation: a review of corneal tattooing. Cornea, 1999, Nov, 18 (6), pp. 633-637.
11. Alio J.L., Sirerol B., Walewska-Szafran A. Corneal Tattooing (keratopigmentation) to restore cosmetic appearance in severely impaired eyes with new mineral micronized pigments. British Journal of Ophthalmology, BMJ Publishing Group, 2010, 94 (2), pp. 245-n/a.
12. Duggan J.N., Nanavati B.P. Tattooing of corneal opacity with gold and platinum chloride. Br. J. Ophthalmol, 1936, 20, pp. 419-425.
13. Alió J.L., Rodriguez A.E., Toffaha B.T., Piñero D.P. et al. Femtosecond-assisted keratopigmentation for functional and cosmetic restoration in essential iris atrophy. J. Cataract Refract. Surg, 2011, Oct, 37 (10), pp. 1744-1747.