Optical coherence tomography (OCT) in laser bonding of incisions in the cornea

Temperature controlled laser bonding of the cornea is analyzed in this paper using optical coherence tomography imaging, histological section evaluations and tensile strength measurements. The heat generated to obtain the bonding causes changes to the tissue structure, which appear as a bowl shaped lesion around the heated spot. Optical coherence tomography is established as an appropriate modality for the assessment of these lesions, using the other methods for validation. A quantitative analysis of the lesions attributes is produced, using a dedicated image processing algorithm. By means of this method we observed that the depth of the lesion is the most effective measure in estimating the extent of the tissue reaction to heat. A comparison of the measured lesion depth, produced by different heating profiles, is presented. This comparison shows a linear dependence on both the temperature and the exposure time, within the boundaries of the experiment. The bond strength was evaluated for several set temperatures (with 20 seconds heating time in each case) displaying an optimal value at 70°C. Yet if an incision was successfully bonded, it held a higher burst pressure for a higher temperature value. These findings demonstrate the plausibility of an integrated laser tissue bonding apparatus with an optical coherence tomography probe, which will provide, for the first time, a real time feedback of the tissue structural change, and indicate the bonding progress and end point.