Karen Joos, Vivien Casagrande, Jin Shen

Working with Stephen Feman, a professor of ophthalmology and a vitreoretinal surgeon, they will determine if the FEL can reattach a torn retina and determine the feasibility of cutting vitreous strands inside the eye that may form following trauma, which causes the retina to detach or separate from the back of the eye.

Using the FEL lasing attachment, Feman will make tiny welding spots to encourage scar tissue to "glue" the retina back in place. "When the retina detaches, cells start dying. What we might be able to do with the FEL is develop protocols to save cells. Once we weld the retina back onto the back of the eye more cells surface and there is a better chance for recovery," Casagrande says.

Vitreous strands (the clear jelly-like substance inside the eye) form as a response to eye trauma, and they tighten like a rubber band on the retina as the eye starts to heal. The strands need to be cut in order to relieve the pressure. "Sometimes that alone is all you need to get small detachments back in position and tack them on," Casagrande says.

In addition Joos, Casagrande, Shen and Debra Shetlar, assistant professor of ophthalmology and a oculoplastic surgeon, plan to determine if the FEL can be used to improve optic nerve sheath surgery.

The optic nerve sheath is the covering for the optic nerve, whose axons transmit vision signals to the brain. When chronic increased intercranial pressure occurs, the squeezed axons die. To relieve the pressure, Shetlar makes tiny holes in the optic nerve sheath to relieve the pressure on the optic nerve.
"Traditionally we do this procedure with a knife and cut a small window, a slit in the optic nerve of 2 to 3 millimeters," Shetlar says. "This works until scarring covers the opening. We're hoping that by using the FEL there will be a more predictable way of making an opening that will remain open over a longer period of time. Our hypothesis is that we will see less tissue damage with the FEL," she says.

Working with FEL Center Director Glenn Edwards and other physicists, Casagrande and Joos also plan to determine if the FEL can be used to alter the molecular structure of ocular tissue and thus be useful for tissue welding to repair traumatic ocular ruptures.

"With this laser we have the potential to examine and determine wavelengths that we have not looked at before and to look at how chemical bonds respond to those wavelengths. Based on how the chemical bonds respond to different wavelengths, there may be procedures we haven't done before that now can be done using a free-electron laser," Joos says.

-Ellen Bourne