THC:YAG laser for sclerostomy in the management of glaucoma

Andrew G. Iwach M.D.; H. Dunbar Hoskins Jr.

doi:10.1117/12.147534

24 June 1993 THC:YAG laser for sclerostomy in the management of glaucoma

Andrew G. Iwach M.D., H. Dunbar Hoskins Jr.

Proceedings Volume 1877, Ophthalmic Technologies III; (1993) https://doi.org/10.1117/12.147534
Event: OE/LASE'93: Optics, Electro-Optics, and Laser Applications in Scienceand Engineering, 1993, Los Angeles, CA, United States

Abstract

A THC:YAG (thulium, holmium, chromium-doped YAG crystal) was used to create sclerostomies in 71 glaucomatous eyes of 67 patients, for a total of 83 procedures. The laser is a long-pulsed (300 microsecond(s) ec), compact, self-contained, solid state laser operating in the near infrared (2.1 (mu) ). A 1 mm conjunctival stab incision was made 12 mm from the sclerostomy site to allow entry of a specially designed 22-gauge (712 (mu) ) optic probe that delivers energy at a right angle to the long axis of the fiber. Probe insertion produced minimal disturbance of the conjunctiva. Pulse energies of 80 to 120 mJ were used with a repetition rate of 5 pulses/sec. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Patients ranged in age from 9 to 90 years. Success was defined as postoperative intraocular pressure <EQ 22 mmHg, or a >= 30% reduction in intraocular pressure if preoperative pressure was <EQ 22 mmHg. One retreatment was permitted if needed in the surgeon's judgment. Success rate was 65% at 12 months and 56% at 21 months. Mean intraocular pressure of successful cases was 13.0 mmHg at 12 months. Success and failure were analyzed relative to patient risk factors.

Citation Download Citation

Andrew G. Iwach M.D. and H. Dunbar Hoskins Jr. "THC:YAG laser for sclerostomy in the management of glaucoma", Proc. SPIE 1877, Ophthalmic Technologies III, (24 June 1993); https://doi.org/10.1117/12.147534

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