Hill R A, Baerveldt G, Ozler S A, Pickford M, Profeta G A, Berns M W
Department of Ophthalmology, University of California, Irvine 92717.
Lasers Surg Med. 1991;11(4):341-6. doi: 10.1002/lsm.1900110405.
As part of a pilot study for glaucoma surgery, the use of 3 infrared solid state lasers with 4 fiber optic delivery systems to ablate human trabecular meshwork was investigated. Laser trabecular ablation (LTA) was attempted with the Erbium:YAG (2.94 microns), Erbium:YSGG (2.79 microns), and Holmium:YSGG (2.1 microns) lasers. Laser energy was delivered as a single pulse (250 microseconds) by tissue fiber optic contact with low hydroxyl-fused silica (200 and 500 microns), zirconium fluoride (250 microns), or sapphire (250 microns) fiber optics. Total energy required and thermal effects decreased as laser wavelength increased. LTA was best achieved at 2.94 microns (4 mJ total energy; energy densities = 8.2-12.7 J/cm2; pulse length 250 microseconds) with average thermal damage zones of 5.3-10.3 +/- 1.3-2.4 microns (means +/- SDs) to contiguous structures. This finding has potential applications in the surgical treatment of open-angle and congenital glaucoma and may minimize failure rates seen in other types of surgery on the trabecular meshwork where disrupted trabecular meshwork is not removed.
作为青光眼手术试点研究的一部分，研究了使用3种红外固态激光器和4种光纤传输系统对人小梁网进行消融。尝试使用铒：钇铝石榴石（2.94微米）、铒：钇钪镓石榴石（2.79微米）和钬：钇钪镓石榴石（2.1微米）激光器进行激光小梁消融（LTA）。激光能量通过与低羟基熔凝石英（200和500微米）、氟化锆（250微米）或蓝宝石（250微米）光纤的组织光纤接触以单脉冲（250微秒）形式传递。随着激光波长增加，所需的总能量和热效应降低。在2.94微米时LTA效果最佳（总能量4 mJ；能量密度 = 8.2 - 12.7 J/cm²；脉冲长度250微秒），对相邻结构的平均热损伤区为5.3 - 10.3 +/- 1.3 - 2.4微米（均值 +/- 标准差）。这一发现可能应用于开角型青光眼和先天性青光眼的手术治疗，并可能降低小梁网其他类型手术中出现的失败率，在这些手术中未切除受损的小梁网。
