Palmer D J, Cohen J, Torczynski E, Deutsch T A
Rush-Presbyterian-St. Luke's Medical Center, Regenstein Eye Center, Chicago, IL., USA.
Ophthalmic Surg Lasers. 1997 Jun;28(6):495-500.
To determine, using autopsy eyes, whether diode laser energy adjustments are indicated in patients with thin sclera.
In the laboratory, the superior 180 degrees of sclera at the limbus was dissected to the level of barely visible anterior uvea and the opposite 180 degrees of sclera served as the control in three human cadaver eyes. A contact G-probe was placed at the limbus, and settings of a diode laser were increased in increments from 1.0 to 9.0 J at 4 burns per setting in each location.
On gross examination, circular hypopigmented lesions were seen in the ciliary body (CB) beginning at 3.0 J in thin sclera and at 5.0 J in normal sclera. On light microscopic examination of thin scleral sections, CB damage began at 2.9 J and CB/ciliary body epithelium (CBE) damage occurred beginning at 3.5 J. In normal sclera, minimal CB/CBE changes occurred at 6.0 to 7.5 J. No scleral damage was visible in either the experimental or the control groups.
Cycloablation energy adjustments are indicated on eyes with abnormally thin sclera to achieve similar histologic end points using the diode laser.
利用尸检眼确定对于巩膜薄的患者是否需要调整二极管激光能量。
在实验室中,在三只人尸体眼睛上,将角膜缘处上方180度的巩膜解剖至仅可见前葡萄膜的水平,相对的180度巩膜作为对照。在角膜缘处放置一个接触式G探头,二极管激光的设置以每次1.0至9.0焦耳的增量增加,每个位置每次设置进行4次烧灼。
大体检查时,在巩膜薄的眼中,从3.0焦耳开始在睫状体(CB)中可见圆形色素脱失病变,在正常巩膜中从5.0焦耳开始可见。在巩膜薄的切片进行光学显微镜检查时,CB损伤从2.9焦耳开始,CB/睫状体上皮(CBE)损伤从3.5焦耳开始出现。在正常巩膜中,在6.0至7.5焦耳时出现最小的CB/CBE变化。在实验组和对照组中均未见到巩膜损伤。
对于巩膜异常薄的眼睛,需要调整睫状体光凝能量,以便使用二极管激光达到相似的组织学终点。