Binder S, Stolba U, Kellner L, Krebs I
Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria.
Am J Ophthalmol. 2000 Jul;130(1):82-6. doi: 10.1016/s0002-9394(00)00399-8.
To evaluate the intraoperative use of a new erbium:yttrium aluminum garnet (YAG) laser vitrectomy system.
An erbium:YAG laser combined with an infusion-suction system (Wavelight Laser Technology, Erlangen, Germany), equipped with a flexible fiber optic and a hand piece with a 20-gauge end tip and a side opening of 0.6 mm was used. Cutting rates were 2 to 30 Hz, and energies were 20 to 40 mJ. Between January 1998 and January 1999 the erbium:YAG laser system was used in 67 consecutive patients (68 eyes) where vitrectomy was indicated. The patients had a complete eye examination before surgery and postoperatively at 1 to 3 days, 1 week, 3 weeks, and 6 weeks. During surgery, the total time needed for vitrectomy, the laser time itself, amount of energy used, cutting rate, suction, and perfusion, as well as manipulative difficulties and/or complications, were documented.
The average laser time was 4.5 minutes for a basic vitrectomy with a setting of 20 mJ, 20 Hz, and suction 100 to 200 mm Hg. Hemorrhages, loose intravitreal, and preretinal membranes of different densities were cut well with adjustment of energy. After a minimal observation time of 6 months (median, 12.7 months) no laser-associated complications were found.
The erbium:YAG laser, combined with an infusion-suction system, offers a new technology for vitreous surgery. Its advantages, compared with mechanical vitrectomy cutters, are higher cutting rates and the modulation of energy. Modifications of the end tip are needed to develop this system further.
评估一种新型铒：钇铝石榴石（YAG）激光玻璃体切割系统的术中应用情况。
使用了一种铒：YAG激光与灌注抽吸系统相结合的设备（德国埃尔朗根的Wavelight激光技术公司生产），该设备配备有可弯曲光纤以及一个带有20号末端尖端和0.6毫米侧开口的手持件。切割频率为2至30赫兹，能量为20至40毫焦。在1998年1月至1999年1月期间，连续67例（68只眼）需要进行玻璃体切割术的患者使用了铒：YAG激光系统。患者在手术前以及术后1至3天、1周、3周和6周进行了全面的眼部检查。手术过程中，记录了玻璃体切割所需的总时间、激光使用时间、能量使用量、切割频率、抽吸和灌注情况，以及操作难度和/或并发症。
在设置为20毫焦、20赫兹以及100至200毫米汞柱抽吸的情况下，基础玻璃体切割术的平均激光使用时间为4.5分钟。通过调整能量，不同密度的出血、玻璃体腔内疏松物和视网膜前膜都能被很好地切割。经过至少6个月（中位数为12.7个月）的观察期，未发现与激光相关的并发症。
铒：YAG激光与灌注抽吸系统相结合，为玻璃体手术提供了一种新技术。与机械玻璃体切割器相比，其优点是切割频率更高且能量可调节。需要对末端尖端进行改进以进一步发展该系统。
