van der Zypen E, Fankhauser F, Kwasniewska S, England C
Department of Anatomy, University of Berne, Switzerland.
Invest Ophthalmol Vis Sci. 1990 Jan;31(1):29-40.
The retinas of six pigmented rabbits (12 eyes) were irradiated with a cw-Nd:YAG laser using two different pulse forms, in conjunction with a constant pulse duration of 200 msec and a retinal focus diameter of 200 microns. The first pulse form (a) was characterized by an initial transient, lasting 15-20 msec, with a peak power twice that of the ensuing plateau phase of 180-185 msec. The second pulse form (b) was almost rectangular in shape. Although the average energies (and powers) for each pulse form were identical, almost 20% of this entity was delivered within the first 20 msec for the first pulse form. Impact lesions were examined at the biomicroscopic, light, and electron microscopic levels, and the characteristic morphologic features described for the cw-mode in general. Comparison of the effects produced using each pulse form revealed a number of differences. At low pulse energies (less than 150 mJ) the rectangular pulse form produced a photocoagulation reaction within the outer sensory retina, but when using the pulse form with the initial transient, this effect was superimposed by a degree of mechanical disruption. Ruptures produced within the elastic component of Bruch's membrane first appeared at lower pulse energies (ie, at 75 mJ, as opposed to 150 mJ for the rectangular pulse form) and were more frequent, and choroidal macrohemorrhaging (observed at pulse energies greater than or equal to 200 mJ) occurred only, when this latter pulse form was employed. Each of these phenomena may be attributed to the higher power and energy densities attained during the initial transient, which has disruptive properties. In order to avoid the risk of severe bleeding, these irradiation parameters should be maintained below approximately 6.4 X 10(3) W/cm2 and approximately 0.13 X 10(3) J/cm2.
