Brazitikos P D, D'Amico D J, Bernal M T, Walsh A W
Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA 02114.
Ophthalmology. 1995 Feb;102(2):278-90. doi: 10.1016/s0161-6420(95)31027-5.
These studies evaluated an erbium:YAG laser for transection of vitreous membranes, retinotomy, and incision and ablation of epiretinal membranes.
Elevated vitreous membranes, detachments, and epiretinal membranes were induced in rabbit eyes. An erbium:YAG laser, emitting at a wavelength of 2.94 microns and equipped with a flexible fiber and endoprobes with tips ranging from 75 to 375 microns, was used to perform vitreous membrane transections, retinotomies, and epiretinal membrane incisions and ablations in nontransmitting aqueous media with the endoprobe in proximity to the tissue. Ablations of epiretinal membranes also were performed in transmitting media, including air and perfluoro-N-octane with the endoprobe elevated above the membrane.
Twenty-five vitreous membrane transections were made in 16 eyes at distances ranging from 0.5 to 4.5 mm from the retina with radiant exposures ranging from 2 to 50 J/cm2 with nonhemorrhagic retinal damage in a single transection. Sharp, linear retinotomies were created successfully in five eyes. Epiretinal membrane ablations were performed with radiant exposures ranging from 1.8 to 22.6 J/cm2. In aqueous media, results of microscopic examination showed partial- to full-thickness ablation with a maximum lateral thermal damage of 50 microns. In air- and perfluoro-N-octane-filled eyes, there was increased lateral damage with desiccation of residual tissue. In 12 aqueous-filled eyes, 18 linear incisions were successfully performed, with retinal nonhemorrhagic damage in 2 eyes and hemorrhage in 5.
The erbium:YAG laser may provide new approaches to maneuvers performed in vitreoretinal surgery.
这些研究评估了铒：钇铝石榴石激光用于玻璃体膜横断、视网膜切开以及视网膜前膜切开和消融的效果。
在兔眼中诱导形成增厚的玻璃体膜、视网膜脱离和视网膜前膜。使用波长为2.94微米、配备有柔性光纤和尖端范围为75至375微米的内探头的铒：钇铝石榴石激光，在非透光性水性介质中，将内探头靠近组织进行玻璃体膜横断、视网膜切开以及视网膜前膜切开和消融。在透光性介质（包括空气和全氟正辛烷）中，将内探头置于膜上方进行视网膜前膜消融。
在16只眼中进行了25次玻璃体膜横断，距视网膜的距离为0.5至4.5毫米，辐射曝光量为2至50 J/cm²，单次横断时视网膜无出血性损伤。在五只眼中成功制作了锐利的线性视网膜切开。视网膜前膜消融的辐射曝光量为1.8至22.6 J/cm²。在水性介质中，显微镜检查结果显示为部分至全层消融，最大横向热损伤为50微米。在充满空气和全氟正辛烷的眼中，残留组织干燥导致横向损伤增加。在12只充满水性介质的眼中，成功进行了18次线性切开，2只眼出现视网膜无出血性损伤，5只眼出现出血。
铒：钇铝石榴石激光可能为玻璃体视网膜手术中的操作提供新方法。
