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Transconjunctival sinusotomy using the 193‐nm excimer laser
Author(s) -
Campos Mauro,
Lee Paul P.,
Trokel Stephen L.,
Taylor Hugh R.,
McDonnell Peter J.
Publication year - 1994
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.1994.tb04685.x
Subject(s) - sclera , conjunctiva , trabecular meshwork , medicine , ophthalmology , trabeculectomy , intraocular pressure , glaucoma , excimer , cornea , ablation , bleb (medicine) , slit lamp , schlemm's canal , aqueous humor , iris (biosensor) , laser , pathology , optics , physics , computer security , biometrics , computer science
. Successful surgical management of glaucoma is limited as a consequence of undesired fibroblastic response of episcleral tissues. In 10 rabbit and three human eye bank eyes, we have performed a modified sinusotomy procedure using the 193‐nm excimer laser. The technique is minimally invasive. Conjunctiva is pulled over the corneoscleral limbus, and a slit‐shaped (1times2 mm) excimer beam ablates through conjunctiva and external sclera until penetrating the outer wall of Schlemm's canal, at which time brisk egress of fluid is noted. The conjunctiva is allowed to retract, and a conjunctival bleb is formed. A single suture is used to close the conjunctival defect. Intraocular pressure in the rabbit eye was decreased from 10.0 ± 1.8 to 4.9 ± 1.8 mmHg immediately after surgery (p < 0.0001). Histology revealed a partial thickness, smooth‐walled ablation consistent with a sinusotomy. This procedure is minimally invasive and may be useful for management of glaucoma, particularly when a substantial component of the impediment to aqueous outflow is external to the trabecular meshwork.