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N.P. Bell, R.L. Gross, S. Orengo-Nania, R.M. Feldman, P. Chevez-Barrios; Short-Application Argon Laser Trabeculoplasty in Human Cadaver Eyes . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1168.
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Purpose: This study will evaluate the histopathologic effect of decreased application time and power argon laser trabeculoplasty (SAALT) in comparison to traditional argon laser trabeculoplasty (ALT). Methods: Argon laser treatment was applied to the trabecular meshwork of 8 human cadaver eyes within 30 hours of death. For adequate visualization of the anterior chamber angle, the cornea was excised, and the globe was placed into a plastic container with an antireflective-coated polymethylmethacrylate (PMMA) artificial cornea on its front surface. Using a mirrored-lens, treatment was applied with an argon green (515nm) photocoagulator using different settings for each quadrant. One quadrant received traditional ALT (power 750 mW; duration 0.1s; size 50 µm). Another quadrant received shorter duration applications of argon laser energy with parameters delivering approximately the same total energy as selective laser trabeculoplasty (power 150 mW; duration 0.01s; size 500 µm (adjacent without overlap)). In the third quadrant, the duration of laser application was held constant at 0.01s, but each globe received either a different power (300, 450, 600, 750, or 900mW), a different spot size (50 or 500 µm), or a combination of changes in both parameters. The final quadrant was left untreated as a control. Then, the globes were immediately fixed in 4% glutaraldehyde solution. The specimens were subsequently evaluated in a masked fashion by light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Results: Trabecular meshwork treated with traditional ALT settings showed evidence of coagulative damage and disruption of tissue. In the areas treated with SAALT, a milder degree of changes were noted in the trabecular meshwork.. Conclusions: Compared with traditional argon laser trabeculoplasty, short-application argon laser trabeculoplasty caused noticeably less coagulative damage to the trabecular meshwork in fresh human cadaver eyes. These findings may warrant further clinical study of efficacy in lowering intraocular pressure in animal models.
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