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Experimental ab interno sclerotomies using a pulsed‐dye laser
Author(s) -
Latina M.,
Goode S.,
de Kater A. W.,
Long F. H.,
Deutsch T. F.,
Epstein D. L.
Publication year - 1988
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.1900080303
Subject(s) - sclera , materials science , laser , cornea , hyphema , absorption (acoustics) , ophthalmology , biomedical engineering , medicine , optics , glaucoma , physics , composite material
We studied the use of a short‐pulse, flashlamp‐pumped dye laser, emitting at 666 nm, to create ab interno sclerotomies in cynomolgus monkeys using a fiberoptic delivery system. Because of the low optical absorption of the sclera in the visible portion of the spectrum, ablation of sclera by continuous wave lasers emitting in this region requires high energies and produces significant thermal damage to surrounding tissues. To enhance the optical absorption of sclera, methylene blue dye was applied iontophoretically; patent sclerotomies were obtained in all 10 eyes of six cynomologus monkeys, with energies ranging from 15 to 50 mj/pulse. Thermal damage to the adjacent sclera was confined to 300 μ/m. Complications included mild intraoperative hyphema at all pulse energies and iridodialysis at higher pulse energies. Filtration blebs routinely failed within 7 days; the use of 5‐fluorouracil postoperatively significantly prolonged bleb duration. The small incision technique described allows ab interno sclerotomies to be created with low pulse energies without the need for conjunctival dissection, thereby avoiding the problems associated with conjunctival wounds. An advantage of this technique is that it can be modified to create ab interno sclerotomies noninvasively by delivering pulsed visible radiation through the cornea with a gonioscopic‐slitlamp system.