Abstract
Abstract: :
Purpose: Excimer Laser Trabeculotomy (ELT) aims to be a minimal invasive method for the reduction of the major amount of outflow resistance, by ablating the anterior juxta-canalicular trabecular meshwork (TM). Endothelium tissue ablation out of Schlemm's canal instead of TM tissue ablation could result in effective reduction of TM resistance. Method: To overcome the outflow resistance of the anterior portion of the TM away from the site of the surgical incision by an almost atraumatic approach without introducing an instrument into the anterior chamber, like ELT, we designed a tip for retrograde Excimer Laser Canalostomy (ELC). Laser Canalostomy was performed with an Excimer Laser (AIDA, Glautec AG, Nürnberg;) with a radiation of 308 nm and a repetition rate up to 20 Hz in four autopsy eyes. Results: The introduction of the side firing tip into Schlemm's canal was possible without rupturing the canal in all four eyes. Light microscopy and scanning electron microscopy of the inner wall of Schlemm's canal adjacent to the anterior chamber showed localized endothelial ablation with minor thermal damage. Conclusion: Retrograde Excimer Laser Canalostomy (ELC) of Schlemm's canal allows for a controlled ablation of the site of major outflow resistance. Further studies are needed to demonstrate the ability for a long lasting reduction of intraocular pressure.
Keywords: 454 laser • 601 trabecular meshwork • 631 wound healing