RESEARCH ARTICLE


Radiofrequency Heating of the Cornea: An Engineering Review of Electrodes and Applicators



Enrique J Berjano*, 1, Enrique Navarro2, Vicente Ribera2, Javier Gorris2, Jorge L Alió3, 4
1 Institute for Research and Innovation on Bioengineering, Technical University of Valencia, Valencia, Spain
2 Neptury Technologies, Almassora, Spain
3 Cornea and Refractive Surgery Department, Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain
4 Pathology and Surgery Department, Universidad Miguel Hernández, Elche, Spain


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Creative Commons License
2007 Bentham Science Publishers Ltd.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Institute for Research and Innovation on Bioengineering, Technical University of Valencia, Valencia, Spain; E-mail: eberjano@eln.upv.es


Abstract

This paper reviews the different applicators and electrodes employed to create localized heating in the cornea by means of the application of radiofrequency (RF) currents. Thermokeratoplasty (TKP) is probably the best known of these techniques and is based on the principle that heating corneal tissue (particularly the central part of the corneal tissue, i.e. the central stroma) causes collagen to shrink, and hence changes the corneal curvature. Firstly, we point out that TKP techniques are a complex challenge from the engineering point of view, due to the fact that it is necessary to create very localized heating in a precise location (central stroma), within a narrow temperature range (from 58 to 76ºC). Secondly, we describe the different applicator designs (i.e. RF electrodes) proposed and tested to date. This review is planned from a technical point of view, i.e. the technical developments are classified and described taking into consideration technical criteria, such as energy delivery mode (monopolar versus bipolar), thermal conditions (dry versus cooled electrodes), lesion pattern (focal versus circular lesions), and application placement (surface versus intrastromal).