Abstract
Abstract: :
Purpose: The free electron laser (FEL) at Amide Band III wavelength (7.7 µm) has been shown to be more effective at cutaneous contraction than the CO2 laser independent of collagen denaturation. Therefore, this wavelength may be effective in closing trabeculectomy leaks. Methods: Trabeculectomies with mitomycin C were performed on 20 pigs. A leaking 1.5 mm hole was punctured in the bleb and closed with cultured skin (Apligraf) + fibrin glue (Tisseel), or cultured skin + fibrin glue + FEL @ 7.7µm. The FEL energy was delivered through a hollow waveguide at 2.9 + 0.5 mJ and 30 Hz. The healing characteristics were followed for 2 weeks. Results: On postoperative day 1, the graft was attached in 40% of cultured skin + fibrin glue-treated bleb holes and 90% of cultured skin + fibrin glue + FEL @ 7.7µm treated-bleb holes. At 1 week, both treatment groups demonstrated healing. Conclusions: In a porcine model of trabeculectomy bleb holes, application of fibrin glue combined with FEL treatment @ 7.7 µm appears useful in enhancing contraction of the fibrin glue and thus sealing leaking trabeculectomies.
Keywords: 454 laser • 631 wound healing • 316 animal model