Khomchik O V, Yusef N Y, Gamidov A A, Gavrilina P D
Research Institute of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2021;137(6):82-86. doi: 10.17116/oftalma202113706182.
Laser cyclodestructive interventions are considered the method of choice in the treatment of refractory glaucoma. However, the traumatic nature of cyclocoagulation makes it necessary to search for more gentle methods of laser treatment. One of the possible directions is the development of laser transscleral technologies that mainly affect the uveoscleral outflow. This article presents a new technique for laser activation of scleral hydropermeability (LASH) using pulse-periodic erbium glass (Er-glass) fiber-optics laser with wave length of 1.56 μm. The article describes the parameters of laser emission and the technique of LASH, and presents the mechanism of reducing intraocular pressure associated with increased transcleral drainage of intraocular fluid by forming new pores in the sclera. The effectiveness and safety of LASH is supported by a detailed example from clinical practice. This technology has proven itself as a possible alternative to the conventional contact transcleral cyclocoagulation.
激光睫状体破坏性干预被认为是治疗难治性青光眼的首选方法。然而,睫状体凝固术的创伤性使得有必要寻找更温和的激光治疗方法。其中一个可能的方向是开发主要影响葡萄膜巩膜外流的激光经巩膜技术。本文介绍了一种使用波长为1.56μm的脉冲周期铒玻璃(Er-玻璃)光纤激光激活巩膜水渗透性(LASH)的新技术。文章描述了激光发射参数和LASH技术,并阐述了通过在巩膜中形成新孔增加眼内液经巩膜引流从而降低眼压的机制。临床实践中的一个详细例子证实了LASH的有效性和安全性。这项技术已证明自己是传统接触式经巩膜睫状体凝固术的一种可能替代方法。