Diode laser-pumped, frequency-doubled neodymium: YAG laser peripheral iridotomy.

BACKGROUND AND OBJECTIVE

The solid-state, continuous-wave, frequency-doubled neodymium: yttrrium-aluminum-garnet (Nd:YAG) laser pumped by a diode laser has several advantages, including air cooling, higher electrical to optical efficiency ratios, portability, and the use of standard 110-V AC electrical service. The authors wanted to evaluate the use of the frequency-doubled Nd:YAG laser for peripheral iridotomy and to compare the tissue interactions of this laser with those of the argon laser.

MATERIAL AND METHODS

The authors developed a diode laser-pumped, solid-state, and portable frequency-doubled Nd:YAG laser with a wavelength of 532 nm. The effects of peripheral iridotomy with the frequency-doubled Nd:YAG laser and the argon laser were evaluated in pig eyes in vitro and in rabbit eyes in vivo. Specimens were prepared for light microscopy and scanning electron microscopy.

RESULTS

The frequency-doubled Nd:YAG laser successfully created patent iridotomies in all animal eyes treated. The following parameters were used to create penetrating burns: duration of 0.1 second, spot size of 100 microns, and power of 500 mW. In rabbit eyes, the mean number of pulses (P = .16) and the total energy required (P = .21) for iridotomy were not significantly different for the argon laser compared with the frequency-doubled Nd:YAG laser. Gross and histologic evaluation showed similar thermal effects in iris tissues for both the frequency-doubled Nd:YAG laser and the argon laser. The mean zone of thermal damage was 178 +/- 19 microns for the frequency-doubled Nd:YAG laser and 163 +/- 24 microns for the argon laser (P = .14). Scanning electron microscopy showed less disruption of the surface of the lesion for the frequency-doubled Nd:YAG laser compared with the argon laser.

CONCLUSIONS

Successful peripheral iridotomy can be performed with the frequency-doubled Nd:YAG laser. Coagulative effects with the frequency-doubled Nd:YAG were similar to those with the argon laser, and the thermal damage zones were comparable in size.