Parameters for neodymium-YAG laser trabeculotomy: an in-vitro study

Area of Science:

• Ophthalmology
• Biophysics
• Medical Laser Technology

Background:

• Glaucoma treatment often involves procedures to reduce intraocular pressure.
• Laser trabeculotomy aims to improve aqueous humor outflow through the trabecular meshwork.
• Precise laser parameters are essential for surgical success and safety.

Purpose of the Study:

• To establish the energy levels of a Q-switched neodymium-YAG laser required to create lesions in human trabecular meshwork in vitro.
• To evaluate the efficacy of different laser convergence angles for lesion production.
• To provide data for optimizing short-pulsed laser internal trabeculotomy procedures.

Main Methods:

• Human corneoscleral tissue explants were used in an in vitro model.
• A Q-switched neodymium-YAG laser with a Trokel gonioscopic lens was employed.
• Lesions were created in the trabecular meshwork at varying energy levels (0.5-7.0 mJ) and convergence angles (10° and 18°).

Main Results:

• Discrete lesions in the trabecular meshwork, without scleral perforation, were achieved at 3.0-5.0 mJ (10° convergence) and 4.0-6.0 mJ (18° convergence).
• The neodymium-YAG laser successfully produced targeted lesions in the trabecular meshwork.
• Specific energy ranges were identified for safe lesion creation.

Conclusions:

• The study identified specific Q-switched neodymium-YAG laser energy levels for effective trabecular meshwork lesion creation in vitro.
• Determining these parameters is critical before clinical application of laser internal trabeculotomy.
• This research supports the development of safer and more precise glaucoma treatments.