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Ab interno and ab externo filtering operations by laser contact surgery
Ophthalmic Surgery
|April 1, 1987
Summary
A novel laser method creates filtering tracts in the eye for glaucoma treatment. This technique uses ultraviolet argon laser via fiberoptics to perforate corneoscleral limbal tissue, forming a filtering fistula.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Laser Surgery
Background:
- Glaucoma management often requires surgical intervention to reduce intraocular pressure.
- Existing surgical methods for creating filtering tracts can have limitations.
- A minimally invasive approach for glaucoma surgery is desirable.
Purpose of the Study:
- To describe a new method for creating filtering tracts in the corneoscleral limbal tissue.
- To evaluate the feasibility of using an ultraviolet argon laser system for this purpose.
- To determine the energy requirements for laser-induced perforation.
Main Methods:
- Utilized an argon gas laser emitting ultraviolet wavelengths (333-363 nm).
- Coupled laser output to fiberoptics (200 microns diameter) with cleaved or ball lens tips.
- Perforated corneoscleral limbal tissue of enucleated bovine eyes to create filtering fistulas.
Main Results:
- Successful creation of filtering tracts using laser perforation.
- Perforation with a 200-micron cleaved fiber required 0.6-1.1 J at 0.5 W for 0.1s.
- A 500-micron ball lens fiber created a 0.5 mm tract needing 5.1-10.4 J at 2.0 W for ≥0.1s.
- Ab interno and ab externo perforation required similar energy levels.
Conclusions:
- A novel ultraviolet laser fiberoptic system can create filtering tracts.
- The method is potentially useful for treating poorly controlled glaucoma.
- Further investigation is warranted for clinical application in glaucoma surgery.