Lieb W. E.

Julius-Maximilians-University, Department of Ophthalmology, Josef-Schneider-Str. 11, 97080 Würzburg

The Erbium YAG-Laser is a laser with a wave length of 2940 nm. Closed to the maximal absorbtion spectrum of water the Erbium YAG-Laser is ideal for tissue ablation with high water contend. In ophthalmology the Erbium AG-Laser has several advantages. Some of them are presently underinvestigationed. Three main areas of glaucoma surgery were investigated with various lasers, especially the Erbium YAG-Laser within the last decade.
1. penetrating laser sclerostomy ab externo and ab interno.
2. trabecular ablation ab interno.
3. lamella sclerectomy ab externo.
The laser sclerostomy was used ab interno and ab externo however long term results could not support initial success. Therefore these techniques were found to be more complicated less successful and with higher complication rates than regular trabeculectomy procedures. Main complications where initial hypotony as well as obliterations of the oesteum with irisprolaps and late scarring. Trabecelablation was already used by hill and co-workers with the Erbium-YAG-Laser. Here the Erbium YAG-Laser showed to be suitable for ablation of fine regular structures. Initial pre-clinical and clinical studies could support those results. As in the skin the Erbium-YAG-Laser can be used as a surgical instrument to ablate tissues of cornea and sclera and might to represent an alternative to the surgical preparation during deep sclerectomy procedures. However up to now the Erbium YAG-Laser is not established within routine glaucoma surgery. Since conventional surgical techniques can at this stage reveal similar results as laser assisted surgery.

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