Near-infrared laser thermal conjunctivoplasty

Jianlong Yang,David Huang,Varun Gopinatth,Tim Boyce,Stephen C Pflugfelder,Rahul Chandwani,Gangjun Liu

doi:10.1038/s41598-018-22204-0

Jianlong Yang, David Huang + Show 5 more

Open Access

https://doi.org/10.1038/s41598-018-22204-0

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Abstract

Conjunctivochalasis is a common cause of tear dysfunction due to the conjunctiva becoming loose and wrinkly with age. The current solutions to this disease include either surgical excision in the operating room, or thermoreduction of the loose tissue with hot wire in the clinic. We developed a near-infrared laser thermal conjunctivoplasty system. The system utilizes a 1460-nm programmable laser diode system as the light source. At this wavelength, a water absorption peak exists and the blood absorption is minimal, so the heating of redundant conjunctiva is even and there is no bleeding. A miniaturized handheld probe delivers the laser light and reshapes the laser into a 10 × 1 mm2 line on the working plane. A foot pedal is used to deliver a preset number of calibrated laser pulses. A fold of loose conjunctiva is grasped by a pair of forceps. The NIR laser light is delivered through an optical fiber and a laser line is aimed exactly on the conjunctival fold by a cylindrical lens. Ex vivo experiments using porcine eye was performed to investigate the induced shrinkage of conjunctiva and decide the optimal laser parameters. It was found that up to 45% of conjunctiva shrinkage could be achieved.

Highlights

The sclera, white part of the eye, is covered by a thin, clear membrane called the conjunctiva
Conjunctivochalasis is a common cause of tear dysfunction (“dry eyes”); it does not respond to the usual dry eye treatments such as artificial tears, punctal plugs and anti-inflammatory drops
Conjunctivochalasis is typically diagnosed by evaluating the conjunctiva for redundant folds that prolapse onto the lower eyelid and obliterate the tear meniscus in that region

Summary

Introduction

The sclera, white part of the eye, is covered by a thin, clear membrane called the conjunctiva. The effects of peak laser power and pulse duty cycle were investigated. With the laser peak power of 1.51 W and duty cycle of 10% (100 ms pulse duration), the temperature increase is very small and the temperature is always below 40 °C [Fig. 1(a)].

Results

Conclusion