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Impressum
Er:YAG-laser-removal of the internal limiting membrane in vitro
Brix A., Vogel A., Winkler J., Dröge G., Birngruber R., Laqua H., Hoerauf H.
Universitäts-Augenklinik Lübeck, Ratzeburger Allee 160, 23538 Lübeck Med. Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, 23562 Lübeck
Objective: To facilitate the surgical removal of the internal
limiting membrane (ILM) we investigated the potential of an Er:YAG-laser
to create reproducible and selective ILM-ablation in vitro.
Methods: Porcine retina explants were treated under perfluorocarbon
liquid using a free running Er:YAG-laser focused either into a low-OH-quartz
fiber or sapphire fiber. After treatment the explants were evaluated by
optical coherence tomography (OCT) and histologic sections.
Results: Both fibers allowed ablation of inner retinal layers.
The sapphire fiber has shown less thermal necrosis and a more homogenous
ablation. A radiant exposure of 2,0 J/ cm2 caused reproducible defects
extending into the nerve fiber layer. Further reduction of the radiant
exposure did not result in selective ILM-removal.
Conclusion: The Er:YAG-laser allowed removal of inner retinal layers
down to the nerve fiber layer. A selective ablation of the ILM was not
possible. In comparison with the low-OH-fiber, the sapphire fiber showed
a higher reproducibility. OCT is a useful and fast diagnostic method to
evaluate ablation down to the nerve fiber layer. Its resolution was not
sufficient to control selective ILM-removal.