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

IF 2.2 3区医学 Q2 DERMATOLOGY

Lasers in Surgery and Medicine Pub Date : 2024-04-03 DOI:10.1002/lsm.23783

Shangbang Luo PhD, Eric R. Mikula PhD, Reza Khazaeinezhad PhD, Samantha M. Bradford PhD, Fengyi Zhang MSc, James V. Jester PhD, Tibor Juhasz PhD

{"title":"Evaluating the effect of pulse energy on femtosecond laser trabeculotomy (FLT) outflow channels for glaucoma treatment in human cadaver eyes","authors":"Shangbang Luo PhD, Eric R. Mikula PhD, Reza Khazaeinezhad PhD, Samantha M. Bradford PhD, Fengyi Zhang MSc, James V. Jester PhD, Tibor Juhasz PhD","doi":"10.1002/lsm.23783","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Objectives</h3>\n \n <p>Femtosecond 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.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>An 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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Pulse 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 (<i>n</i> = 6), a partial-thickness channel (<i>n</i> = 2), and a full-thickness FLT channel (<i>n</i> = 2). There was a statistically significant difference in cutting widths between the 10 and 15 μJ groups (<i>p</i> < 0.0001), as well as between the 10 and 20 μJ groups (<i>p</i> < 0.0001). However, there was no statistically significant difference between the 15 and 20 μJ groups (<i>p</i> = 0.416).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Fifteen 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.</p>\n </section>\n </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 4","pages":"382-391"},"PeriodicalIF":2.2000,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lasers in Surgery and Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lsm.23783","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Objectives

Femtosecond 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 Methods

An 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.

Results

Pulse 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).

Conclusions

Fifteen 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.

查看原文本刊更多论文

评估脉冲能量对飞秒激光小梁切开术（FLT）流出通道的影响，在人体尸体眼睛中治疗青光眼

背景和目的飞秒激光小梁切开术（FLT）可通过小梁网（TM）形成房水外流通道，是治疗开角型青光眼的一种新兴无创疗法。本研究的目的是探讨 FLT 过程中脉冲能量对流出通道形成的影响。材料和方法使用 FLT 激光器（ViaLase 公司）在人体尸体眼球中创建流出通道（宽 500 μm，高 200 μm），脉冲能量分别为 10、15 和 20 μJ。处理后，将组织固定在 4% 多聚甲醛中。使用光学相干断层扫描（OCT）对通道进行成像，并评估为全厚度、部分厚度或不可观察。结果 15 和 20 μJ 的脉冲能量在通过 OCT 成像创建全厚 FLT 通道方面的成功率为 100%。10 μJ 脉冲能量导致无通道（n = 6）、部分厚度通道（n = 2）和全厚度 FLT 通道（n = 2）。10 μJ 组和 15 μJ 组之间以及 10 μJ 组和 20 μJ 组之间的切割宽度差异有统计学意义（p < 0.0001）。然而，15 和 20 μJ 组之间的差异没有统计学意义（p = 0.416）。结论 15 微焦耳的脉冲能量足以在人体尸体眼睛的 FLT 过程中可靠地创建房水流出通道。OCT 是评估 FLT 的重要工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.