Erbium-YAG Laser Surgery on Experimental Vitreous Membranes

Margolis, Thomas I.; Farnath, Denise A.; Destro, Maryanna; Puliafito, Carmen A.

doi:10.1001/archopht.1989.01070010434040

Cited by 69 publications

(14 citation statements)

References 23 publications

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“…[4][5][6][7][8][9][10][11][12][13][14][15] Some of these attempts have failed to achieve widespread acceptance because of the problems associated either with deep collateral damage induced in the surrounding tissue (carbon dioxide laser, Ho:YAG laser) 4,5 or with the adverse effects from using radiation in the eye (xenon chloride excimer laser). 6 The Er:YAG laser [7][8][9][10] and argon fluorine excimer laser 11,12 intraocular systems have been successfully tried in both animal and human surgery, including attempts at transection and ablation of epiretinal and subretinal membranes, segmentation of the vitreous base, and capsulotomy. 10,13 Despite the demonstrated advantages of precise dissection of ocular tissue in liquid media, both of these systems have failed to achieve widespread acceptance in practice because of their prohibitively high cost, large size, and relatively slow pace.…”

Section: Arch Ophthalmol 2005;123:1412-1418mentioning

confidence: 43%

Pulsed Electron Avalanche Knife (PEAK-fc) for Dissection of Retinal Tissue

Priglinger

Haritoglou²,

Palanker³

et al. 2005

Arch Ophthalmol

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Methods: Porcine retina (in vivo) and human retina (in vitro) were incised with the PEAK-fc using various pulse parameters. The globes were then processed for light microscopy. Evaluation of all specimens focused on depth of the retinal cuts and on the degree of collateral damage.Results: Retinal cuts performed both in vivo on porcine eyes and on human donor eyes showed very sharp edges with only little collateral damage. With probes of 600 µm in length, the optimal pulse parameters for pre-cise and reproducible cutting of the retina were an amplitude of 350 to 380 V, a repetition rate of 300 Hz, and 30 "minipulses" per pulse of 100-microsecond duration. With increasing voltage, cuts also affected the retinal pigment epithelium and the choroid, followed by intravitreal bleeding during in vivo application. Conclusion:We demonstrated that PEAK-fc is capable of precisely cutting retinal tissue in vivo and in vitro using optimal pulse parameters. Further in vivo studies will be necessary to determine the efficacy of this new tractionless cutting device in vitreoretinal surgery.

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Section: Arch Ophthalmol 2005;123:1412-1418mentioning

confidence: 43%

Pulsed Electron Avalanche Knife (PEAK-fc) for Dissection of Retinal Tissue

Priglinger

Haritoglou²,

Palanker³

et al. 2005

Arch Ophthalmol

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“…Quartz and sapphire rods with tip diameters ranging from 75 to 375 µm have been used by being inserted into a handpiece incorporating a 20-G hollow stainless steel tube associated with a 1-meter silicon optical fiber [33]. In these studies [39], an Er:YAG laser was successfully used for complete transections of transvitreal membranes in rabbit eyes, inducing a narrow zone of thermal damage (15–60 µm) [32, 33, 34, 35, 36]. …”

Section: Invasive Methods:the Ultraviolet and Infrared Laserssupporting

confidence: 44%

Laser Vitreolysis

Fankhauser

Kwasniewska²

2002

Ophthalmologica

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Strands and vitreous adhesion bands can either be dissected noninvasively, transpupillarily by photodisruptive pulses of a Nd:YAG laser, operated in the photodisruptive mode, or invasively using an Er:YAG laser and specialized fibers. The previously used CO₂, Ho:YAG, and ultraviolet lasers have become less popular in the recent past. When using the transpupillary method, specialized contact lenses are required. Noninvasive methods avoid the risks incurred with invasive methods, but they require specialized knowledge, which is not available usually in vitreoretinal services. The invasive laser method provides a number of advantages typical of laser-tissue interaction. Advances in electrosurgical methods have opened the door to a new class of miniaturized electrosurgical equipment with which tissue dissection is made possible by plasma due to dielectrical breakdown which allows the pulse energy to be reduced to a very low level, resulting in a highly localized tissue effect. None of these methods has yet been considered for clinical use, mainly because the presently used mechanical methods are thought to be optimal by the majority of vitreoretinal surgeons.

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“…CO, lasers also produce large areas of damage [51 and require a cumbersome delivery system [6,71. Visible lasers do not ablate lens because the tissue is Er-YAG ablation has been successfully shown in skin, bone, cornea, iris, lens, retina, vitreous membranes, aorta, and atheromatous plaque [5-93. Ho-YAG lasers have been used to ablate gastric mucosa, liver, and sclera [lo-121.…”

mentioning

confidence: 44%

Erbium‐YAG and holmium‐YAG laser ablation of the lens

Ross

Puliafito

1994

Lasers Surg Med

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Er-YAG (2.9 microns, 200 microseconds pulsewidth) and Ho-YAG (2.12 microns, 250 microseconds pulsewidth) lasers were used to irradiate bovine crystalline lenses. Mass ablated increased with increasing fluence for both lasers and was greater for the Er-YAG than the Ho-YAG laser at all fluences. The mass loss vs. fluence curve was nonlinear for the Er-YAG and linear for the Ho-YAG laser. Ablation threshold was lower for the Er-YAG. Grossly, the Er-YAG laser produced less charring and expressed fewer, smaller tissue pieces than the Ho-YAG. Scanning electron microscopy indicated that the Er-YAG produced smoother walled craters. The Ho-YAG laser produced more dessicated and disrupted craters. The Er-YAG radiation, delivered by fiberoptic probes, may provide a method of performing minimally invasive cataract surgery.

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Erbium-YAG Laser Surgery on Experimental Vitreous Membranes

Cited by 69 publications

References 23 publications

Pulsed Electron Avalanche Knife (PEAK-fc) for Dissection of Retinal Tissue

Pulsed Electron Avalanche Knife (PEAK-fc) for Dissection of Retinal Tissue

Laser Vitreolysis

Erbium‐YAG and holmium‐YAG laser ablation of the lens

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