Continuous and pulsed microwaterjet in ophthalmology

At the present time, visual recovery after a penetrating keratoplasty is relatively poor. This is caused by the techniques and tools used to perform this operation. In order to improve these results the authors propose a new cutting tool for the cornea. This paper explains the surgery, the reasons of its limitations and some techniques proposed to improve the results as well. Then the device used to carry out the authors' trials and the method followed to perform the cuts with the microwaterjet are presented. Then results obtained in different conditions with continuous and pulsed microjets are discussed and compared to trephine and laser methods thanks to a histological study. The authors determined 20 bars pressure and 0.30 mm diameter is the best compromise to be used with the continuous microjet and 20 bars pressure and 0.36 mm diameter with pulsation frequency of 80 Hz the best one for pulsed microjet. Also, the authors showed microwaterjet doesn't create damage to the tissue (contrary to laser treatment), allows one to obtain quasi-straight edges of cut (contrary to using trephine) but generates a hydration put in order by the tissue.