Short-term effects of Q-switched ruby laser on monkey anterior chamber angle

Three Q-switched ruby laser pulses were applied to the trabecular meshwork of 10 monkey eyes. Pulse energies ranging from 20 to 110 mJ were studied. The spot size ranged from 100 to 200 micrometer (in air), and the pulse durations was 28 sec. Gonioscopic examinations showed a graded response from no appreciable change at 20 mJ per pulse to marked disruption of anterior chamber angle structures at 100 mJ or more per pulse. Perfusions done within an hour of treatment showed no consistent alteration of the outflow facility. Scanning electron microscopy demonstrated the graded anterior chamber angle response. No disruption of the angle structures was seen after the 20 mJ treatment, but discrete trabecular damage occurred after treatments with 25 mJ. After pulses equal to or greater than 45 mJ the anterior chamber angle structures were markedly altered. The power density causing extensive tissue disruption was equal to or greater than 150 X 10(8) watts/cm2. In each specimen with an identifiable trabecular lesion, tissue debris and endothelial edema were found on the adjacent inner surface of the cornea. Tearing of Descemet's membrane next to the trabecular meshwork occurred with the 100 mJ pulses.