Shirato S, Adachi M, Yamashita H
Department of Ophthalmology, University of Tokyo School of Medicine, Japan.
Jpn J Ophthalmol. 1990;34(3):381-7.
A full-thickness sclerostomy was carried out with an ab interno approach, using an argon endolaser, in 9 eyes of 7 rhesus monkeys. After the injection of sodium hyaluronate into the subconjunctival space and the anterior chamber, a 300 micron fiber optic probe coupled with a water-cooled argon laser was inserted into the anterior chamber through the corneal incision made by a 23-gauge needle and positioned on the trabecular meshwork opposite to the corneal incision. A patent sclerostomy was obtained in all 9 eyes by 1 to 3 laser pulses with an energy of 4 W and a pulse duration of 0.5 seconds. After the surgery, 0.1 ml of 5-fluorouracil was injected subconjunctivally every day for one week. Intraocular pressure (IOP) was determined by pneumatic tonometer for one month at appropriate intervals. Mean preoperative IOP was 22 mmHg in both operated and nonoperated eyes. After one month IOP was 4.6 +/- 0.4 mmHg lower in the operated eyes than in the nonoperated eyes. Histologic study revealed that the sclerostomies from the anterior chamber opening to the subconjunctival space with the diameter of 200-300 microns still remained patent one month after surgery. Ab interno sclerostomy with an argon endolaser would be useful as a new filtering procedure which can easily be performed with minimum conjunctival damage.
采用经内路方法，使用氩离子眼内激光，对7只恒河猴的9只眼睛进行了全层巩膜造瘘术。在结膜下间隙和前房内注射透明质酸钠后，将一根与水冷氩离子激光耦合的300微米光纤探头通过23号针头制作的角膜切口插入前房，并置于与角膜切口相对的小梁网上。通过1至3次激光脉冲，能量为4瓦，脉冲持续时间为0.5秒，在所有9只眼睛中均获得了通畅的巩膜造瘘口。术后，每天结膜下注射0.1毫升5-氟尿嘧啶，持续一周。使用气动眼压计以适当的间隔测定眼内压（IOP）一个月。手术眼和未手术眼术前平均IOP均为22 mmHg。一个月后，手术眼的IOP比未手术眼低4.6±0.4 mmHg。组织学研究显示，从手术一个月后，从房水开口到结膜下间隙直径为200-300微米的巩膜造瘘口仍保持通畅。氩离子眼内激光经内路巩膜造瘘术作为一种新的滤过手术是有用的，它可以很容易地进行，对结膜的损伤最小。
