All Laser "Top Hat" Surgery and Video

Indianapolis Surgeon Performs World’s First
All-Laser “Top Hat” Cornea Transplant

Indianapolis, IN, Nov. 28. Corneal transplant surgery - the most common type of solid tissue transplant - has taken a giant leap forward with the recent performing of the world’s first all-laser ‘Top Hat’ corneal transplant procedure by Indianapolis eye surgeon Francis W. Price, Jr., MD. Dr. Price used a high-speed laser to precisely cut a graft designed to provide faster and stronger healing compared with traditional transplant methods.

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A TopHat transplant has 4 steps:

• Laser dissection of the recipient cornea
• Laser dissection of the donor cornea
• Removal of the recipient cornea
• Placement and suturing of the donor cornea

“This is easily the most dramatic breakthrough we’ve seen in corneal transplant surgery in the past decade,” said Dr. Price. “The femtosecond laser allows us to now produce complex contours and custom designs for each transplant patient which not only dramatically improve the visual recovery and healing process, but also gives us the potential to enhance visual outcomes.”

The femtosecond laser used by Dr. Price was made by IntraLase Corp, Irvine CA.  The laser fires 15,000 pulses per second, with each pulse lasting only 400 quadrillionths of a second. (As an illustration of how brief a femtosecond laser pulse lasts, in one second a pulse of light can travel around the equator of the Earth seven times, whereas in one femtosecond a pulse of light can only travel the width of three human hairs.)   A computer and sophisticated optics were used to precisely position the pulses in the cornea to create the desired transplant design.

While most traditional cornea transplants provide the patient with a clear cornea, it usually takes 6 to 12 months for patients to recover good vision, and even then strong glasses or contact lens are often required.  Sutures typically remain in place for a year or more because the cornea is slow to heal, and a traditional transplant always remains a weak spot and vulnerable to injury for the remainder of the patient’s life.  With the femtosecond laser the surgeon can create a precisely shaped incision that should heal faster, allow more rapid suture removal, and heal stronger, minimizing the risk of subsequent injury.

The Top Hat procedure is so named because of the innovative “hat” shaped incision.  This design provides a “lip” of tissue, which laboratory studies suggest may create a seal 10 times stronger than the simple circular disc shaped incision used in traditional transplants. The transplant recipient’s eye is prepared by the same laser that cuts the donor tissue, so the new tissue fits perfectly.

Cornea transplants are the most common type of solid tissue transplant, with approximately 30,000 performed in the United States each year.

About The Cornea Research Foundation of America:
The Cornea Research Foundation of America (CRFA) was founded by Dr. Francis Price, Jr., M.D. in 1988 with a mission to establish a world center for clinical research and education specializing in corneal disease, corneal transplantation and intraocular lens surgery