Lasers in Glaucoma: an Overview

Saha, Bhawesh Chandra; Kumari, Rashmi; Sinha, Bibhuti Prassan; Ambasta, Anita; Kumar, Sanjeev

doi:10.1007/s10792-020-01654-4

Cited by 9 publications

(5 citation statements)

References 109 publications

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“…Consequently, the ablation achieved is much larger than the actual laser spot, which can lead to side effects and additional clinical patterns such as ghost images, iris bleeding, corneal endothelial damage or retinal detachment. Furthermore, the tissue ablation with ns laser sources depends on the linear absorption properties of the tissue and therefore on the color of the eye (1)(2)(3)(4)(5)(6)(7). However, such unintended results can be counteracted by using ultrashort pulses (USP) (8)(9)(10)(11)(12)(13).…”

Section: Open Access Edited Bymentioning

confidence: 99%

Ophthalmic surgeries on post mortem porcine eyes with picosecond ultrashort laser pulses

Körber,

Fellinger,

Fritsche

et al. 2024

Front. Med.

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PurposeThis work demonstrates significant advantages in ophthalmic surgeries through the use of picosecond ultrashort laser pulses instead of state-of-the-art nanosecond laser pulses. These ultrashort lasers shall serve as universal tools more effectively combining advantages of high precision, low impact and economic advantages compared to existing instruments.MethodsAs samples, we used post-mortem porcine eyes on which we performed the experiments with both picosecond and nanosecond lasers. Performed surgeries were laser iridotomy, (post-) cataract treatment/capsulotomy and selective laser-trabeculoplasty. Pulse widths were between 12 ps and 220 ns with pulse energies between 30 μJ and 10 mJ at 532 nm and 1,064 nm. Additionally, we investigated accompanying shock waves, cavitation bubbles, and heat effects during the ablation processes.ResultsFor all surgeries, significant differences were observed between picosecond and nanosecond pulses: It was possible to scale the pulse energy down to 10 of microjoules rather than requiring millijoules, and resulting tissue ablations are much more precise, more deterministic and less frayed. The shock wave and cavitation bubble investigation revealed major differences in pressure between picosecond pulses (0.25 MPa, 50 μJ) and nanosecond pulses (37 MPa, 5 mJ). The heat input during ablation could be lowered by two orders of magnitude.ConclusionPicosecond ultrashort laser pulses show substantial benefits for several ophthalmic surgeries, with regard to ablation precision, shock wave generation and heat input. They are better than state-of-the-art ophthalmic nanosecond lasers in all aspects tested.

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Section: Open Access Edited Bymentioning

confidence: 99%

Ophthalmic surgeries on post mortem porcine eyes with picosecond ultrashort laser pulses

Körber,

Fellinger,

Fritsche

et al. 2024

Front. Med.

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“…Several possible post-laser complications have been reported following this procedure including transient rise in intraocular pressure, posterior synechiae formation, transient blurred vision, choroidal effusion, formation of focal lens opacities, corneal decompensation, aqueous misdirection, retinal hemorrhages and choroidal and retinal detachment. 5 We report here a case of patient who developed blurred vision in his left eye after getting LPI in his both eyes simultaneously.…”

Section: Introductionmentioning

confidence: 95%

Loss of Vision after Laser Peripheral Iridotomy: A Case Report

2021

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Laser Peripheral Iridotomy (LPI) is a common laser procedure carried out in patients with narrow or occluded irido-corneal angles at risk of developing angle closure glaucoma. Nd-YAG and Argon laser are used sequentially in our local population to create an iridotomy. Posterior segment complications are rare after this procedure and generally can occur due to direct laser induced damage. We report a 44-year old patient, who had LPI performed on his both eyes. Post laser patient complained of reduced vision in his left eye and was evaluated in our glaucoma clinic. On examination, his vision was 20/25 unaided in his right eye and 20/60 in his left eye with no further improvement. Optical coherence tomography (OCT) revealed presence of cystoid macular edema (CME) in his left eye responsible for his reduced vision. Key Words: Laser Peripheral Iridotomy, Cystoid Macular Edema, Argon Laser.

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“…This is the only therapeutic strategy that prevents damage to the optic nerve and the progression of visual field defects [ 2 ]. Anti-glaucoma medications, most of which work by lowering aqueous production or increasing outflow, as well as laser procedures, such as peripheral iridotomy or trabeculoplasty, are generally considered to be first-line therapy [ 3 ]. Surgery is usually indicated when glaucoma medications and lasers are unable to reduce IOP sufficiently to halt visual field loss [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Recent Advancements in Glaucoma Surgery—A Review

Ang,

Lim,

Betzler

et al. 2023

Bioengineering

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Surgery has long been an important treatment for limiting optic nerve damage and minimising visual loss in patients with glaucoma. Numerous improvements, modifications, and innovations in glaucoma surgery over recent decades have improved surgical safety, and have led to earlier and more frequent surgical intervention in glaucoma patients at risk of vision loss. This review summarises the latest advancements in trabeculectomy surgery, glaucoma drainage device (GDD) implantation, and minimally invasive glaucoma surgery (MIGS). A comprehensive search of MEDLINE, EMBASE, and CENTRAL databases, alongside subsequent hand searches—limited to the past 10 years for trabeculectomy and GDDs, and the past 5 years for MIGS—yielded 2283 results, 58 of which were included in the final review (8 trabeculectomy, 27 GDD, and 23 MIGS). Advancements in trabeculectomy are described in terms of adjunctive incisions, Tenon’s layer management, and novel suturing techniques. Advancements in GDD implantation pertain to modifications of surgical techniques and devices, novel methods to deal with postoperative complications and surgical failure, and the invention of new GDDs. Finally, the popularity of MIGS has recently promoted modifications to current surgical techniques and the development of novel MIGS devices.

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Lasers in Glaucoma: an Overview

Cited by 9 publications

References 109 publications

Ophthalmic surgeries on post mortem porcine eyes with picosecond ultrashort laser pulses

Ophthalmic surgeries on post mortem porcine eyes with picosecond ultrashort laser pulses

Loss of Vision after Laser Peripheral Iridotomy: A Case Report

Recent Advancements in Glaucoma Surgery—A Review

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