Determination of an appropriate laser setting for THC-YAG laser sclerostomy ab externo in rabbits

To determine an appropriate setting for the THC-YAG laser (chromium-sensitized, thulium, and holmiumdoped YAG laser), we performed sclerostomy ab externo on 24 pigmented rabbits. The laser energy was delivered via a subconjunctivally-inserted fiberoptic probe that was placed at the limbus through a small conjunctival incision. We used four pulse-energy levels to perform the sclerostomies: 80 mJ, 120 mJ, 160 mJ, and 200 mJ. At all these levels, a new outflow pathway was easily created, a filtering bleb was formed, and intraocular pressure (IOP) was immediately reduced. Severe tissue damage around the sclerostomy site occurred with the 160-millijoule and 200-millijoule pulses. The 80-millijoule pulse created a relatively small patent sclerostomy, providing only relatively brief IOP reduction. We conclude that 120-millijoule is the most appropriate laser-pulse energy for use in pigmented rabbits.