Dietlein T S, Jacobi P C, Mietz H, Krieglstein G K
Department of Ophthalmology, University of Cologne, Germany.
Ophthalmic Surg Lasers. 2001 Nov-Dec;32(6):483-5.
Laser trabecular ablation (LTA) is an abinterno approach with the purpose to improve outflow facility by removing trabecular tissue and open Schlemm's canal. In a blind eye with secondary glaucoma following silicone oil surgery, Erbium:YAG LTA had been performed applying 12 neighboring single laser pulses (5-7 mJ pulse energy, 200 micros pulse duration) to the trabecular meshwork. Enucleation was performed three years after the procedure that did not achieve pressure control. Light-microscopy revealed neither marked scarring nor endothelial proliferation in the treated trabecular meshwork. However, most of the recognizable ablation craters failed to open Schlemm's canal. Although limited scar formation within the trabecular meshwork after LTA is a promising aspect, the present technique of Er:YAG LTA still needs technical and surgical improvements to guarantee reliable and reproducible openings of Schlemm's canal.
激光小梁消融术(LTA)是一种内路手术方法,旨在通过去除小梁组织和开放施莱姆管来改善房水流出易度。在硅油手术后继发青光眼的盲眼中,已对小梁网施加12个相邻的单个激光脉冲(脉冲能量5 - 7 mJ,脉冲持续时间200微秒)进行铒:钇铝石榴石激光小梁消融术。在该手术未能实现眼压控制三年后进行了眼球摘除术。光学显微镜检查显示,在接受治疗的小梁网中既没有明显的瘢痕形成,也没有内皮细胞增殖。然而,大多数可识别的消融坑未能开放施莱姆管。尽管LTA后小梁网内有限的瘢痕形成是一个有前景的方面,但目前的铒:钇铝石榴石激光小梁消融术技术仍需要技术和手术改进,以确保施莱姆管可靠且可重复的开放。