Erbium-YAG laser surgery on experimental vitreous membranes

We used a pulsed erbium-YAG laser emitting in the midinfrared region (2.94 microns) to cut experimental vitreous membranes in rabbits via an intraocular fiberoptic delivery system. Thirty-four membranes were cut at distances of 500 to 3600 microns from the retina. All 34 of the membranes treated were effectively cut. Sixteen cases had no evidence of retinal injury, including one in which the membrane was only 800 microns from the retina. Retinal injuries in the remaining cases consisted of small (less than 300 microns) retinal burns and hemorrhages. In 94% of the cases with retinal injury, the fiberoptic was within 2000 microns of the retina. We conclude that a pulsed erbium-YAG laser allows near tractionless cutting of vitreous membranes and may have potential for clinical use if further studies show it to be efficacious and safe near the retina.