First-in-Human Safety Study of Femtosecond Laser Image-Guided Trabeculotomy for Glaucoma Treatment

Nagy, Zoltán Zsolt; Kránitz, Kinga; Ahmed, Iqbal Ike K.; Francesco, Ticiana De; Mikula, Eric; Juhász, Tibor

doi:10.1016/j.xops.2023.100313

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…Further investigation of OCT imaging follow-ups is needed to assess the long-term outcomes after surgery. 14 It is important to discuss the acceptance criteria defined in this study for a "full channel," which was defined as a channel with a continuous cutting width of F I G U R E 9 A representative 3D image stack of the iridocorneal angle, oriented from different perspectives, illustrates a wedge-shaped FLT outflow channel cut through the trabecular meshwork (TM) and extending into Schlemm's canal (SC). This channel was created using a pulse energy of 20 μJ, effectively establishing a direct connection between SC and the aqueous fluid in the anterior chamber (AC).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, femtosecond laser trabeculotomy (FLT) has emerged as a noninvasive, non-incisional method to bypass aqueous humor outflow resistance. [12][13][14] The use of a femtosecond laser for glaucoma treatment has several advantages. First, a tightly focused femtosecond laser beam enables photodisruption or laser-induced optical breakdown to occur only at a well-defined focal spot, resulting in localized and confined tissue removal.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the effect of pulse energy on femtosecond laser trabeculotomy (FLT) outflow channels for glaucoma treatment in human cadaver eyes

Luo,

Mikula,

Khazaeinezhad

et al. 2024

Lasers Surg Med

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Background and ObjectivesFemtosecond laser trabeculotomy (FLT) creates aqueous humor outflow channels through the trabecular meshwork (TM) and is an emerging noninvasive treatment for open‐angle glaucoma. The purpose of this study is to investigate the effect of pulse energy on outflow channel creation during FLT.Materials and MethodsAn FLT laser (ViaLase Inc.) was used to create outflow channels through the TM (500 μm wide by 200 μm high) in human cadaver eyes using pulse energies of 10, 15, and 20 μJ. Following treatment, tissues were fixed in 4% paraformaldehyde. The channels were imaged using optical coherence tomography (OCT) and assessed as full thickness, partial thickness, or not observable.ResultsPulse energies of 15 and 20 μJ had a 100% success rate in creating full‐thickness FLT channels as imaged by OCT. A pulse energy of 10 μJ resulted in no channels (n = 6), a partial‐thickness channel (n = 2), and a full‐thickness FLT channel (n = 2). There was a statistically significant difference in cutting widths between the 10 and 15 μJ groups (p < 0.0001), as well as between the 10 and 20 μJ groups (p < 0.0001). However, there was no statistically significant difference between the 15 and 20 μJ groups (p = 0.416).ConclusionsFifteen microjoules is an adequate pulse energy to reliably create aqueous humor outflow channels during FLT in human cadaver eyes. OCT is a valuable tool when evaluating FLT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating the effect of pulse energy on femtosecond laser trabeculotomy (FLT) outflow channels for glaucoma treatment in human cadaver eyes

Luo,

Mikula,

Khazaeinezhad

et al. 2024

Lasers Surg Med

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“…Femtosecond laser, image-guided, highprecision trabeculotomy (FLIGHT) is an even less invasive technology for goniotomy [5]. Optical coherence tomography guided channels are formed in the trabecular meshwork using photodisruption.…”

Section: Minimally Invasive Glaucoma Surgerymentioning

confidence: 99%

Glaucoma surgical procedures under development

Levin,

Sheybani

2023

Current Opinion in Ophthalmology

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Purpose of review Rapid innovation in glaucoma surgery is expanding surgical options in the angle, subconjunctival space, and supraciliary space. Recent findings Advancements in glaucoma surgery make it possible for surgeons to provide treatments with less risk. In particular, new devices and lasers are available for minimally invasive glaucoma surgeries. There are also new implants and techniques for bleb-forming glaucoma surgery. Summary As glaucoma surgeons have access to an increasing number of procedures, devices, and treatments, it is important for evidence to drive decision-making.

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How it works: Lasers

Clarkson

2024

Optician

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First-in-Human Safety Study of Femtosecond Laser Image-Guided Trabeculotomy for Glaucoma Treatment

Cited by 4 publications

References 32 publications

Evaluating the effect of pulse energy on femtosecond laser trabeculotomy (FLT) outflow channels for glaucoma treatment in human cadaver eyes

Evaluating the effect of pulse energy on femtosecond laser trabeculotomy (FLT) outflow channels for glaucoma treatment in human cadaver eyes

Glaucoma surgical procedures under development

How it works: Lasers

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