Schirner G, Huber A, Wördemann A, Dröge G, el-Hifnawi E, Birngruber R, Brinkmann R
Augenklinik, Medizinische Universität zu Lübeck.
Ophthalmologe. 1994 Oct;91(5):638-45.
So far the dose-effect ratio of the Holmium laser (wavelength 2.12 microns) and the erbium laser (1.54 microns) for laser thermokeratoplasty (LTK) are not defined in detail. Our study was designed not only to compare the erbium contact and the holmium non-contact applications but also to throw light on the influence of different geometrical application patterns, pulse energies, pulses per coagulation site and repetition rates under experimental conditions. Enucleated sheep and pig eyes were used 2-6 h post mortem, pressurized to 25 mmHg and moisturized with saline solution. Before and after LTK, pachymetry and keratometry were performed. Some specimens were prepared for light and scanning microscopy. The coagulation threshold for the erbium laser in a contact mode with a 200-microns fibre was 25 J/cm2 (ca. 8 mJ/pulse) and for the holmium laser 8 J/cm2 (ca. 2.5 mJ/pulse). The erbium laser was used in a single shot per spot mode, the holmium laser in repeated pulse per spot mode. With the single shot per spot mode, we were able to induce a promising hyperopic shift of up to -3.47 +/- 0.61 D, while myopic changes could only be induced up to +1.89 +/- 0.74 D. Higher changes of up to +8.27 +/- 1.3 D could be achieved by means of repeated pulses per spot (20 pulses, 45 mJ, 10 Hz). Our experiments showed an obvious increase of dioptric changes when using a higher repetition rate while pulse energy and number were kept constant.(ABSTRACT TRUNCATED AT 250 WORDS)
迄今为止,钬激光(波长2.12微米)和铒激光(1.54微米)用于激光角膜热成形术(LTK)的剂量效应比尚未详细明确。我们的研究不仅旨在比较铒激光接触式应用和钬激光非接触式应用,还旨在阐明在实验条件下不同几何应用模式、脉冲能量、每个凝固点的脉冲数和重复率的影响。使用死后2 - 6小时的摘除羊眼和猪眼,加压至25 mmHg并用盐溶液保湿。在LTK前后,进行角膜厚度测量和角膜曲率测量。一些标本制备用于光学显微镜和扫描显微镜检查。铒激光在接触模式下使用200微米光纤时的凝固阈值为25 J/cm²(约8 mJ/脉冲),钬激光为8 J/cm²(约2.5 mJ/脉冲)。铒激光采用每个光斑单次照射模式,钬激光采用每个光斑重复脉冲模式。在每个光斑单次照射模式下,我们能够诱导出高达 -3.47 ± 0.61 D的有前景的远视性移位,而近视性改变最多只能诱导出 +1.89 ± 0.74 D。通过每个光斑重复脉冲(20个脉冲,45 mJ,10 Hz)可实现高达 +8.27 ± 1.3 D的更高变化。我们的实验表明,在脉冲能量和数量保持不变的情况下,使用更高的重复率时屈光度变化明显增加。(摘要截短于250字)