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[Ab interno trabeculectomy with the Nd:YLF picosecond laser]
K Rohrschneider1, F E Kruse, R Kessler
1Universitäts-Augenklinik, Ruprecht-Karls-Universität Heidelberg. Klaus_Rohrschneider@med.uni-heidelberg.de
Background:
The outcome of glaucoma surgery is limited by scar formation. As an alternative to current techniques, the opening of the trabecular meshwork ab interno may lead to increased outflow. This study examined the Nd:YLF picosecond laser for ab interno ablation of the trabecular meshwork without opening of the eye.
Patients And Methods:
A Nd:YLF picosecond laser was used which allows tissue to be ablated even through fluids. We performed ablation with different spot sizes and energies in postmortem eyes. Afterwards the effect of the laser treatment was examined by electron microscopy.
Results:
The ablation threshold for the cornea was found to be 20 J/cm2 for a pulse width of 30 ps. At a lower level of energy (10 J/cm2) ablation of the trabecular meshwork was possible. The size of the focus which was limited by the optics of the slit-lamp was about 50 microns.
Conclusion:
These initial results with a Nd:YLF picosecond laser confirm the possibility of ablating tissue in the trabecular meshwork ab interno without the need to open the eye.