1. Subconjunctival THC:YAG Laser Thermal Scierostomy
- Author
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Arthur Vassiliadis, Andrew G. Iwach, H. Dunbar Hoskins, Michael V. Drake, and David R. Hennings
- Subjects
Adult ,Male ,Intraocular pressure ,medicine.medical_specialty ,chemistry.chemical_element ,Glaucoma ,law.invention ,Filtering surgery ,law ,Solid-state laser ,medicine ,Humans ,Child ,Sclerostomy ,Intraocular Pressure ,Aged ,Aged, 80 and over ,business.industry ,Middle Aged ,Laser ,medicine.disease ,eye diseases ,Surgery ,Ophthalmology ,Treatment Outcome ,chemistry ,Female ,Fluorouracil ,Laser Therapy ,sense organs ,Sclerostomies ,Holmium ,Nuclear medicine ,business ,Conjunctiva ,Follow-Up Studies - Abstract
A THC:YAG laser (thulium, holmium, chromium-doped YAG crystal) was used to create thermal sclerostomies in 21 glaucomatous eyes of 19 patients. The laser is a long-pulsed (300 µsec), compact, self-contained, solid state laser operating in the near infrared (2.1 µ). A 1-mm conjunctiva) stab incision was made 12 mm away from the sclerostomy site to allow entry of a specially designed 22-gauge (712 µ) optic probe that delivers energy at a right angle to the long axis of the fiber. Probe insertion produced minimal disturbance of the conjunctiva. Pulse energies of 80 mJ to 120 mJ were used with a repetition rate of 5 pulses/second. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 4.8 J. Subconjunctival 5-fluorouracil injections were administered in 15 eyes. At 3 months the mean intraocular pressure of successful cases (16) was 14 mmHg (range, 9 to 22 mmHg). Of successful cases, the mean intraocular pressure at 6 months was 13 mmHg (range, 2 to 22 mmHg). Five cases failed within the initial 3 months, and 3 additional cases failed by 6 months. The authors conclude that this full-thickness sclerostomy technique may simplify filtering surgery without anterior chamber instrumentation and with minimal conjunctiva) trauma.
- Published
- 1991
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