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January 1985, Vol 103, No. 1 >
ARTICLE | January 1985

Q-Switched Neodymium-YAG Laser Trabeculopuncture in Monkeys FREE

David L. Epstein, MD; Carmen A. Puliafito, MD; Jean Pei, MD; Shlomo Melamed, MD
[+] Author Affiliations

Accepted for publication Nov 20, 1984.

Reprint requests to the Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114 (Dr Epstein).


Arch Ophthalmol. 1985;103(1):129-133. doi:10.1001/archopht.1985.01050010135037
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• In nine cynomolgus monkeys, trabeculopuncture was performed with a Q-switched neodymium-YAG laser, using a pulse energy of 5 to 7 millijoules and an exposure time of 14 nanoseconds. A penetration into Schlemm's canal was successfully achieved with two to four pulses; this penetration was accompanied by intraocular pressure (IOP) reduction and blood reflux into the anterior chamber. However, after eight days, IOP returned to baseline level, while white tissue was observed gonioscopically to fill in the puncture sites. Histologically, one hour after laser treatment, a blasting effect on the trabecular meshwork was observed with no signs of necrosis. Ater eight days, a hypertrophic scar formed, with the corneal endothelium extending over the scarred surface. At eight weeks and at six months after laser treatment, further shrinkage of the scar and the formation of a membrane over it was evident. Attempts to control scar formation by preventing blood reflux or injecting fluorouracil subconjunctivally for two weeks were unsuccessful. Scar formation at the trabecular puncture site severely limits the applicability of this potentially simple glaucoma treatment.

REFERENCES

1 +
Krasnov MM:  Q-switched laser iridectomy and Q-switched laser goniopuncture . Adv Ophthalmol 1977;;34:192-196.
2 +
Krasnov MM:  Q-switched laser goniopuncture . Arch Ophthalmol 1974;;92:37-41.
3 +
Krasnov MM:  Laserpuncture of anterior chamber angle in glaucoma . Am J Ophthalmol 1973;;75:674-678.
4 +
Bonney CH, Gaasterland DE, Rodrigues MM, et al:  Shortterm effects of Q-switched ruby laser on monkey anterior chamber angle . Invest Ophthalmol Vis Sci 1982;;22:310-318.
5 +
Ticho U:  Laser application to the angle structures in animals and in human glaucomatous eyes . Adv Ophthalmol 1977;;34:201-210.
6 +
Witschel B, Cannheim F, Rassow B:  Experimental studies on laser trabeculopuncture . Adv Ophthalmol 1977;;34:197-200.
7 +
Ticho U, Cadet JC, Mahler J, et al:  Argon laser trabeculotomies in primates: Evaluation by histological and perfusion studies . Invest Ophthalmol Vis Sci 1980;;17:667-673.
8 +
Wickham MG, Wortenen DM:  Argon laser trabeculotomy: Long-term follow-up . Ophthalmology 1979;;86:495-503.
9 +
Worthen DM, Wickham MG:  Laser trabeculotomy in monkeys . Invest Ophthalmol Vis Sci 1973;;12:707-711.
10 +
Ticho U, Zauberman H:  Argon laser application to the angle structures in the glaucomas . Arch Ophthalmol 1976;;94:61-64.
11 +
Van-der Zypen E, Fankhauser F:  Lasers in the treatment of chronic simple glaucoma . Trans Ophthalmol Soc UK 1972;;102:147-153.
12 +
Van-der Zypen E, Fankhauser F:  The ultrastructural features of laser trabeculopuncture and cyclodialysis . Ophthalmologica 1979;;175:189-200.
13 +
Van-der Zypen E, Bebie H, Fankhauser F:  Morphological studies about the efficiency of laser beams upon the structures of the angle of the anterior chamber . Int Ophthalmol 1979;;1,2:109-122.
14 +
Rodrigues MM, Spaeth GL, Donohoo P:  Electron microscopy of argon laser therapy in phakic open angle glaucoma . Ophthalmology 1982;;89:198-210.
15 +
Blumenkranz MS, Ophir A, Claflin AJ, et al:  Fluorouracil for the treatment of massive periretinal proliferation . Am J Ophthalmol 1982;;94:458-467.
16 +
Gressel MG, Parrish RK, Folberg R:  5-Fluorouracil and glaucoma filtering surgery: I. An animal model . Ophthalmology 1984;;91:378-383.
17 +
Heuer DK, Parrish RK, Gressel MG, et al:  5-Fluorouracil and glaucoma filtering surgery: II. A pilot study . Ophthalmology 1984;;91:384-393.
18 +
Rootman J, Tisdall J, Gudauskas G, et al:  Intraocular penetration of subconjunctivally administered 14C-fluorouracil in rabbits . Arch Ophthalmol 1979;;97:2375-2378.

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1 +
Krasnov MM:  Q-switched laser iridectomy and Q-switched laser goniopuncture . Adv Ophthalmol 1977;;34:192-196.
2 +
Krasnov MM:  Q-switched laser goniopuncture . Arch Ophthalmol 1974;;92:37-41.
3 +
Krasnov MM:  Laserpuncture of anterior chamber angle in glaucoma . Am J Ophthalmol 1973;;75:674-678.
4 +
Bonney CH, Gaasterland DE, Rodrigues MM, et al:  Shortterm effects of Q-switched ruby laser on monkey anterior chamber angle . Invest Ophthalmol Vis Sci 1982;;22:310-318.
5 +
Ticho U:  Laser application to the angle structures in animals and in human glaucomatous eyes . Adv Ophthalmol 1977;;34:201-210.
6 +
Witschel B, Cannheim F, Rassow B:  Experimental studies on laser trabeculopuncture . Adv Ophthalmol 1977;;34:197-200.
7 +
Ticho U, Cadet JC, Mahler J, et al:  Argon laser trabeculotomies in primates: Evaluation by histological and perfusion studies . Invest Ophthalmol Vis Sci 1980;;17:667-673.
8 +
Wickham MG, Wortenen DM:  Argon laser trabeculotomy: Long-term follow-up . Ophthalmology 1979;;86:495-503.
9 +
Worthen DM, Wickham MG:  Laser trabeculotomy in monkeys . Invest Ophthalmol Vis Sci 1973;;12:707-711.
10 +
Ticho U, Zauberman H:  Argon laser application to the angle structures in the glaucomas . Arch Ophthalmol 1976;;94:61-64.
11 +
Van-der Zypen E, Fankhauser F:  Lasers in the treatment of chronic simple glaucoma . Trans Ophthalmol Soc UK 1972;;102:147-153.
12 +
Van-der Zypen E, Fankhauser F:  The ultrastructural features of laser trabeculopuncture and cyclodialysis . Ophthalmologica 1979;;175:189-200.
13 +
Van-der Zypen E, Bebie H, Fankhauser F:  Morphological studies about the efficiency of laser beams upon the structures of the angle of the anterior chamber . Int Ophthalmol 1979;;1,2:109-122.
14 +
Rodrigues MM, Spaeth GL, Donohoo P:  Electron microscopy of argon laser therapy in phakic open angle glaucoma . Ophthalmology 1982;;89:198-210.
15 +
Blumenkranz MS, Ophir A, Claflin AJ, et al:  Fluorouracil for the treatment of massive periretinal proliferation . Am J Ophthalmol 1982;;94:458-467.
16 +
Gressel MG, Parrish RK, Folberg R:  5-Fluorouracil and glaucoma filtering surgery: I. An animal model . Ophthalmology 1984;;91:378-383.
17 +
Heuer DK, Parrish RK, Gressel MG, et al:  5-Fluorouracil and glaucoma filtering surgery: II. A pilot study . Ophthalmology 1984;;91:384-393.
18 +
Rootman J, Tisdall J, Gudauskas G, et al:  Intraocular penetration of subconjunctivally administered 14C-fluorouracil in rabbits . Arch Ophthalmol 1979;;97:2375-2378.

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