<title>Laser sclerostomy ab externo with the Erbium:YAG laser using a new flexible application system</title>

Abstract

A fistula from the anterior chamber of the eye into the subconjunctival space can be created by laser application ab externo (laser sclerostomy). The success of the procedure mainly depends on the special application system. The pulsed Erbium-YAG laser (2940 nm) was used as the energy source. The laser energy was guided to the application system via a ZrFl fiber with low attenuation at this wavelength. Because this fiber cannot be used in direct contact to the sclera, an optical coupling unit transmitted the energy to a short quartz fiber. This fiber was inserted in a specially sharpened retractable cannula to guide it into the subconjunctival space. Then the laser energy could be applied directly to the sclera to form the fistula. The procedure was demonstrated in vivo using rabbit eyes. A working fistula with formation of a filtering bleb could be achieved. The trauma to the conjunctiva was as minimal as in a subconjunctival injection. The minor alteration of the conjunctiva in this procedure compared to traditional surgical methods like goniotrepanation or trabeculectomy may cause less scarification and therefore less failure.© (1992) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.