ABSTRACT
Authors performed transscleral diode laser retinopexy through the conjunctiva, muscle and silicone scleral exoplant to evaluate its safety and efficacy in experimental rabbit eyes. Transscleral applications required energies of average 325. 2 mWwith duration of 0.5 second. The mean power required to produce comparable lesions through the conjunctiva, muscle and the buckle(MIRA #276)was 27%, 20%, and 33%higher, respectively. These results demonstrate that the diode laser photocoagulation applied through a scleral buckle is capable to produce chorioretinal scars without damaging the scleral tissue nor the buckling elements employed.
Subject(s)
Cicatrix , Conjunctiva , Lasers, Semiconductor , Light Coagulation , SiliconesABSTRACT
Authors performed transscleral diode laser retinopexy to evaluate its safety and efficacy in human eyes. Transscleral diode laser retinopexy was performed on 75 human eyes of rhegmatogenous retinal detachment. Power setting ranged from 400 to 1,000 mW, duration setting ranged from 0.5 to 1.0 second, and average 107 laser spots(range 15-443 laser spots) were applied. Seventy four of 75 eyes(98.7%) achieved anatomical success in reattachment after 6 months follow-up period. Complications of treatment encountered were minor Bruch's membrane rupture in 2 eyes, small retinal hemorrhage in one eye and mild scleral thermal burn in one eye. These complications did not affect adversely the surgical results. Among the 75 eyes, 21 eyes underwent diode laser choroidotomy for drainage of subretinal fluid with success. Transscleral diode laser retinopexy was considered as a safe and effective mean to obtain chorioretinal adhesion in retinal detachment surgery.
Subject(s)
Humans , Bruch Membrane , Burns , Drainage , Follow-Up Studies , Lasers, Semiconductor , Retinal Detachment , Retinal Hemorrhage , Retinaldehyde , Rupture , Subretinal FluidABSTRACT
Transscleral diode laser retinopexy and cryoretinopexy were performed in pigmented rabbits, and light and electron microscopic, and immunohistochemical studies were done. Acute lesions produced by cryoretinopexy showed significant retinal destruction and, in contrast, those produced by transscleral diode laser showed reaction limited to the outer retina and choroid. Chronic lesions by cryoretinopexy showed marked retinal thinning and chorioretinal adhesions. Pigment-laden cells were aggregated at the level of the retinal pigment epithelium, with some having migrated into the sensory retina. The laser lesions showed similar findings but less in size and severity. Acute lesions showed absence of reactivity with all antibodies. While marked expressions of GFAP, vimentin, and S-100 epitopes were seen in chorioretinal scar tissues made with cryoretinopexy, expressions with less intensity were seen with diode retinopexy. Migrating pigment-laden cells were labelled positive for cytokeratins and few cells were positive for anti-macrophage antibody. These results suggest that although transscleral diode laser induce less inner retinal destruction and more localized burns than cryoretinopexy, both forms of treatment produce similar deep retinal Muller cell reaction, as demonstrated by the immunohistochemical studies.