Wetzel W, Otto R, Falkenstein W, Schmidt-Erfurth U, Birngruber R
Eye Surgery Center Weinheim, Germany.
Ger J Ophthalmol. 1995 Sep;4(5):283-8.
The erbium:YAG laser is a preferable energy source for laser sclerostomy ab externo due to the high absorption of its radiation (2940-nm wavelength) in the aqueous parts of scleral tissue. It has thus far been a disadvantage that laser energy has to be transmitted from the laser source to the application site via very susceptible special optical fibers (ZrF). As a consequence of technical improvements, the laser source could be integrated into the application probe. Therefore, only a robust quartz fiber was necessary for contact application. A fiber diameter of 400 microns was chosen according to the experience gained in previous studies. A total of 24 eyes with chronical open-angle glaucoma were treated. A fistula end-point detection unit was developed for safe indication of a full-thickness perforation of the sclera. With a fiber diameter of 400 microns, a postoperative success rate of about 54% was achieved at 6 months follow-up. The automated full-thickness perforation detection prevented the application of additional, surplus laser pulses in the anterior chamber. The postoperative success rate could be improved over that achieved in previous studies. The new device/conception offers more technical reliability and is a further step toward minimally invasive fistulating laser surgery of open-angle glaucoma.
钇铝石榴石激光是一种理想的用于外路激光巩膜造瘘术的能量源，因为其辐射（波长2940纳米）在巩膜组织的水性部分具有高吸收率。到目前为止，一个缺点是激光能量必须通过非常易损的特殊光纤（ZrF）从激光源传输到应用部位。由于技术改进，激光源可以集成到应用探头中。因此，接触应用仅需要一根坚固的石英光纤。根据先前研究获得的经验，选择了400微米的光纤直径。共治疗了24只慢性开角型青光眼眼。开发了一种瘘管终点检测装置，用于安全指示巩膜的全层穿孔。使用400微米的光纤直径，在6个月的随访中实现了约54%的术后成功率。自动全层穿孔检测可防止在前房施加额外的多余激光脉冲。术后成功率可以比先前研究中取得的结果有所提高。这种新装置/概念提供了更高的技术可靠性，是朝着开角型青光眼微创造瘘激光手术迈出的又一步。
