Lee Jong Yeon, Ha Seung Yeon, Paik Hae Jung, Kwon Kun-Young, Kim Yong Yeon
Department of Ophthalmology .
Curr Eye Res. 2014 Sep;39(9):908-16. doi: 10.3109/02713683.2014.884596. Epub 2014 Feb 21.
Patterned laser trabeculoplasty (PLT) was introduced as it claimed to cause less thermal damage and provide more uniform coverage of the trabecular meshwork than argon laser trabeculoplasty (ALT). The objective of this study was to investigate morphologic changes in the trabecular meshwork after PLT or ALT in cats.
We performed ALT in the right eyes and PLT in the left eyes of 6 domestic cats. A seventh cat was assigned as a control. Two ranges of laser energy were used for PLT: supra-threshold energy of 400-450 mW in 3 cats and sub-threshold energy of 250 to 350 mW in 3 cats. Specimens were obtained at 1, 4 and 9 weeks after treatment. Structural changes in the trabecular meshwork were evaluated by light microscopy and scanning electron microscopy.
The trabecular meshwork after supra-threshold PLT revealed coagulative damage such as a crater-like lesion with disruption of trabecular beams in early period and extensive membranous obliteration in the late period (at 4 and 9 weeks after treatment), which were comparable to tissue changes after ALT. Sub-threshold PLT resulted in thinning of the uveal meshwork and denudation of trabecular endothelial cells whereas it did not disrupt trabecular beams. Nevertheless, following sub-threshold PLT, partial membranous coverages were observed in the trabecular meshwork in the late period.
When used at sub-threshold power, PLT caused less thermal damage to the trabecular meshwork than ALT. However, it did not effectively prevent late scarring of the trabecular meshwork in cats.
有创激光小梁成形术(PLT)问世,据称与氩激光小梁成形术(ALT)相比,其造成的热损伤更小,对小梁网的覆盖更均匀。本研究的目的是调查猫在接受PLT或ALT后小梁网的形态学变化。
我们对6只家猫的右眼进行ALT,左眼进行PLT。将第7只猫作为对照。PLT使用了两个激光能量范围:3只猫使用400 - 450 mW的阈上能量,3只猫使用250至350 mW的阈下能量。在治疗后1周、4周和9周获取样本。通过光学显微镜和扫描电子显微镜评估小梁网的结构变化。
阈上PLT后的小梁网在早期显示出凝固性损伤,如小梁束中断的火山口样病变,后期(治疗后4周和9周)出现广泛的膜性闭塞,这与ALT后的组织变化相当。阈下PLT导致葡萄膜小梁变薄和小梁内皮细胞剥脱,但未破坏小梁束。然而,阈下PLT后,后期在小梁网中观察到部分膜性覆盖。
当以阈下功率使用时,PLT对小梁网造成的热损伤比ALT小。然而,它并不能有效防止猫小梁网的晚期瘢痕形成。