martes, 29 de junio de 2010

Pachymetry Assisted Laser Keratoplasty (PALK)

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An innovative, ground-breaking method for corneal transplantation developed by Dr. Cesar Carriazo, Centro Oftalmológico Carriazo, Colombia as a result of a close and long-term cooperation with SCHWIND eye-tech-solutions. With the SCHWIND AMARIS, the pachymetry assisted laser keratoplasty (PALK) is an easy, safe and extremely precise procedure. It is suited for patients who need corneal transplants and whose endothelium is intact.
The comprehensive diagnostic measurement of corneal pachymetry combined with laser-guided ablation provide a so far unequalled level of precision in removing damaged corneal surfaces, homogeneity of residual stromal bed thickness as well as a shorter surgical time. Up to now, PALK has shown excellent visual results and has significantly reduced risks associated with other techniques. “With PALK, we are broadening the spectrum of treatment provided by the SCHWIND AMARIS, thus continuously expanding the leading technological position of the TotalTechLaser“, Rolf SCHWIND, CEO of SCHWIND, points out.

PALK-CAM precisely determines the ablation volume
The surgical procedures most commonly applied in the past for transplantations replacing diseased or damaged corneas are the penetrating keratoplasty and lamellar keratoplasty. However, these methods present their own risks, complications and vision results. The PALK technique developed by Dr. Carriazo in cooperation with SCHWIND opens up new dimensions in corneal transplantation.
A module of the SCHWIND-CAM software (PALK-CAM) available for the SCHWIND AMARIS laser precisely determines the ablation volume of the host cornea based on a detailed pachymetry map. At a high resolution in all dimensions, the AMARIS laser then ablates the calculated volume. This technique combines all advantages of lamellar keratoplasty, but additionally provides individualized corneal ablation ensuring homogeneity of residual stromal thickness, thus leading to better postsurgical visual results. According to the clinical experience of Dr. Carriazo gathered with preliminary software versions and in pilot studies, the treated eyes had an excellent transparency at the donor-host interface and most of them had less than 15% loss of endothelial cells. No rejection of the graft was observed. In addition, it was significantly better centred as compared to non-laser based techniques.

Contact-free method
Dr. Carriazo sums up his experience with PALK like this: “Patients improved their vision in both quantity and quality and additionally have the opportunity to more effective post-keratoplasty refractive corrections because with the PALK technique, they have gained extra corneal thickness and almost normal corneas in terms of anatomy. The risks are lower than those with the traditional technique, since the incidence of complications is very low.” According to Dr. Carriazo the major advantages of laser treatment with the PALK-CAM are the contact-free
method without exerting mechanical pressure on the eye, the centring done by the eye tracking system, the minimal endothelial loss and the safety and reproducibility of the procedure, together with shorter surgical time with the SCHWIND AMARIS. “Furthermore, the PALK technique preserves endothelium and Descemet membrane of the host, and survival is increased as compared to PKP. The possibility of rejection is minimal because the transplanted immune load is lower“, Dr. Carriazo sums up.

Source: http://www.eye-tech-solutions.com/fileadmin/files/documents/pdf-files/Aktuelles/Pressemitteilungen/2009/PR_PALK_04-2009-E.pdf

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