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Abstract #8690 Published in IGR 5-1
Intracanalicular trabeculostomy with the Er:YAG laser
Kampmeier J; Bentele A; Stock K; Wagner P; Hibst R; Lang GE; Steiner R; Lang GKOphthalmologe 2002; 99: 927-932
PURPOSE: To develop a new ab externo technique for glaucoma trabecular surgery using the infrared Er:YAG laser radiation (2.9 μm) guided into Schlemm's canal by an optical fiber. MATERIAL AND METHODS: In order to create a drainage canal to the anterior chamber, a quartz fiber (core diameter: 100 μm) coupled to an Er:YAG laser was shielded by a metal canula (diameter: 280 μm), bent in conformance to the curvature of Schlemm's canal. A 45°-mirror enabled the laser radiation to exit the canula perpendicular to the fiber axis. The complete surgery device was tested on agar medium and enucleated human eyes. RESULTS: Using the unshielded quartz fiber, eight pulses of 8 mJ (frequency: 7 Hz, pulse duration: 150μsec) were sufficient to perforate the trabecular meshwork of the human eye. Histology showed a rippled canal with 50 μm average diameter and a surrounding necrosis zone of 15-35 μm. The complete device could easily be inserted into Schlemm's canal similarly to the classic trabeculostomy probe, and a conical-shaped canal with a length of 2-3 mm could be created in agar medium within a few seconds. CONCLUSIONS: Initial experience in an experimental set-up shows the ab externo creation of a draining canal between Schlemm's canal and the anterior chamber with only minimal irritation in the surrounding tissue. Further refinements of the laser parameters and the biomechanical set-up resulted in a new hand-held device with improved function. Er:YAG laser intracanalicular trabeculostomy could become a new ab externo technique for minimal invasive therapy for open angle glaucoma.LA: German
Dr. J. Kampmeier, Universitatsklinikum Ulm, Augenklinik, Germany. yvonne.hesse@medizin.uni-ulm.de
Classification:
12.8.4 Using laser (Part of: 12 Surgical treatment > 12.8 Filtering surgery)