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Related Experiment Videos

Laser sclerostomy ab externo using mid infrared lasers

W Wetzel1, M Scheu

  • 1Clinic for Opthalmology, University Eye Hospital, Kiel, Germany.

Ophthalmic Surgery
|January 1, 1993
PubMed
Summary

Pulsed lasers like Holmium:YAG and Erbium:YAG can create a patent fistula for glaucoma treatment. The Erbium:YAG laser demonstrated fewer complications and less energy requirement than the Holmium:YAG laser.

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Laser Surgery

Background:

  • Glaucoma management often requires surgical intervention to reduce intraocular pressure.
  • Ab externo fistulizing procedures aim to create a new drainage pathway for aqueous humor.
  • Laser technology offers potential for minimally invasive ophthalmic surgical techniques.

Purpose of the Study:

  • To evaluate the efficacy and safety of pulsed Holmium:YAG (Ho:YAG) and Erbium:YAG (Er:YAG) lasers for ab externo fistulization in a rabbit model.
  • To compare the outcomes of Ho:YAG and Er:YAG laser sclerostomy in terms of fistula patency, intraocular pressure reduction, and complications.

Main Methods:

  • Ab externo sclerostomy was performed in 48 rabbit eyes using pulsed Ho:YAG (20 and 200 microseconds) and Er:YAG (200 microseconds) lasers.
  • Laser energy was delivered via an infrared transmitting fiber inserted into a retractable cannula in the subconjunctival space.
  • An optical fiber-fiber coupling system was utilized for the Er:YAG laser delivery.

Main Results:

  • A patent fistula (200-micrometers diameter) and filtering bleb were achieved in most cases, leading to significant intraocular pressure reduction.
  • The 20-microsecond Ho:YAG laser was associated with significant intraoperative and postoperative complications.
  • The Er:YAG laser resulted in a smaller thermal damage zone and required less energy compared to the Ho:YAG laser.
  • Conjunctival trauma was minimal, comparable to subconjunctival injection.

Conclusions:

  • Pulsed Er:YAG and Ho:YAG lasers are effective in creating fistulas for glaucoma treatment in rabbits.
  • Er:YAG laser appears to be a safer and more efficient option, with less thermal damage and lower energy requirements.
  • Further investigation into laser-assisted glaucoma surgery is warranted.

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