Shah Rohan J, Shen Jin H, Joos Karen M
Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Lasers Surg Med. 2007 Aug;39(7):589-96. doi: 10.1002/lsm.20531.
This study proposed to develop a technique for efficiently accessing the posterior orbital space using endoscopy and attempted application of free electron laser (FEL) energy, biopsy forceps, electrocautery, and CO(2) insufflation to posterior orbital tissues.
Through an inferior transconjunctival incision, access to the posterior orbital space was attempted in 14 eyes of 7 non-survival pigs. FEL energy (6.1 microm, 30 Hz, delivered via 250 microm hollow-glass waveguide), biopsy forceps, and monopolar electrocautery application were endoscopically attempted in the posterior orbit. CO(2) gas insufflation effects were assessed by analyzing arterial blood gases at 30-minute intervals for 1.5 hours.
The posterior orbit was accessed in 13 of 14 eyes, the optic nerve was encountered, and FEL energy was applied in 8 of 14 eyes. Use of biopsy forceps and electrocautery were successful. Although ANOVA results for arterial blood gas changes were not statistically significant, visibility was adequate without CO(2) insufflation.
The posterior orbit was endoscopically accessed and the optic nerve was exposed and successfully treated with FEL energy. CO(2) insufflation did not alter blood gases, but did not further enhance visibility in this study.
本研究旨在开发一种利用内窥镜有效进入眶后间隙的技术，并尝试将自由电子激光（FEL）能量、活检钳、电灼术和二氧化碳注入应用于眶后组织。
通过下睑结膜切口，对7只非存活猪的14只眼尝试进入眶后间隙。在内窥镜下对眶后尝试应用FEL能量（6.1微米，30赫兹，通过250微米中空玻璃波导传输）、活检钳和单极电灼术。通过每隔30分钟分析动脉血气1.5小时来评估二氧化碳气体注入的效果。
14只眼中的13只成功进入眶后间隙，遇到视神经，并在14只眼中的8只应用了FEL能量。活检钳和电灼术的使用成功。尽管动脉血气变化的方差分析结果无统计学意义，但在不进行二氧化碳注入的情况下视野也足够清晰。
通过内窥镜进入眶后间隙，暴露视神经并成功用FEL能量进行治疗。在本研究中，二氧化碳注入未改变血气，但也未进一步提高视野清晰度。
